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Clin Shoulder Elbow > Volume 17(4); 2014 > Article
Clinics in Shoulder and Elbow 2014;17(4):152-158.
DOI: https://doi.org/10.5397/CiSE.2014.17.4.152    Published online December 31, 2014.
Short-term of Reverse Total Shoulder Arthroplasty for the Treatment of Irreparable Massive Rotator Cuff Tear
Jong Hyuk Park, Seong Il Wang, Byung Chang Lee
1Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea. wsi1205@naver.com
2Naeun Hospital, Iksan, Korea.
Received: 13 June 2014   • Revised: 26 August 2014   • Accepted: 14 September 2014
Abstract
BACKGROUND: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs).
METHODS
Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups.
RESULTS
Mean pain VAS improved, from 6.6+/-1.2 to 2.7+/-0.9 (p=0.001), and the mean functional VAS from 35.7+/-4.2 to 73.3+/-5.4 (p=0.006). The mean ASES score improved from 37.2+/-2.8 to 75.0+/-3.8 (p=0.012). The mean KSS improved from 36.5+/-7.2 to 75.6+/-5.4 (p=0.009), the mean forward elevation from 66.3+/-4.7 to 135.6+/-8.4 (p=0.0001), and the mean abduction from 45.2+/-4.2 to 119.0+/-6.5o (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture.
CONCLUSIONS
RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.
Key Words: Rotator cuff; Massive; Arthropathy; Shoulder; Arthroplasty


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