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Clin Shoulder Elbow > Volume 17(2); 2014 > Article
Clinics in Shoulder and Elbow 2014;17(2):68-76.
DOI:    Published online March 31, 2014.
Reverse Total Shoulder Arthroplasty: Early Outcome and Complication Report
Yong Bok Park, Sung Weon Jung, Ho Young Ryu, Jin Ho Hong, Sang Hoon Chae, Kyoung Bin Min, Jae Chul Yoo
1Department of Orthopaedic Surgery, Samsung Medical Center, Seoul, Korea.
2Department of Orthopaedic Surgery, Samsung Changwon Hospital, Changwon, Korea.
3Sports Medicine Center, Samsung Medical Center, Seoul, Sungkyunkwan University School of Medicine, Korea.
Received: 31 March 2014   • Revised: 26 May 2014   • Accepted: 3 June 2014
BACKGROUND: Recently, reverse total shoulder arthroplasty (RTSA) has been accepted as a main treatment option in irreparable massive rotator cuff tear with cuff arthropathy. The purpose of this study was to evaluate the early complication incidence and the preliminary clinical results of RTSAs performed in single institute.
Fifty-seven RTSAs (56 patients) were performed between April 2011 and March 2013. The indications for RTSA were cuff tear arthropathy and irreparable massive rotator cuff tear with or without pseudoparalysis. Exclusion criteria were revision, preoperative infections and fractures. At final follow-up, 45 shoulders were enrolled. Mean follow-up duration was 12.5 months (range, 6-27 months). The mean age at the time of surgery was 73.6 years (range, 58-87 years). All the patients were functionally accessed via Constant score, American Shoulder and Elbow Surgeons (ASES) score, pain and functional visual analogue scale (VAS) scores and active range of motion. Complications were documented as major and minor. Major complications include fractures, infections, dislocations, nerve palsies, aseptic loosening of humeral or glenoid components, or glenoid screw problems. Minor complications include radiographic scapular notching, hematomas, heterotopic ossification, algodystrophy, intraoperative dislocations, intraoperative cement extravasation, or radiographic lucent lines of the glenoid.
The mean Constant score increased from 31.4 to 53.8 (p < 0.001). The pain and functional VAS scores improved (5.2 to 2.7, p < 0.001, 4.0 to 6.7, p < 0.001) and active forward flexion improved from 96.9degrees to 125.6degrees (p = 0.011). One or more complications occurred in 16 (35.6%) of 45 shoulders, with one failure (2.2%) resulting in the removal of implants by late infection. The single most common complication was scapular notching (9 [20%]). There were 4 (8.9%) axillary nerve palsies postoperatively (n=3: transient n. palsy, n=1: Symptom existed at 11 months postoperatively but improving).
In a sort term follow-up, RTSA provided substantial gain in overall function. Most common early complications were scapular notching and postoperative neuropathy. Although overall early complication rate was as high as reported by several authors, most of the complications can be observable without compromise to patients' clinical outcome. Long term follow-up is required to clarify the clinical result and overall complication rate.
Key Words: Shoulder; Arthroplasty; Reverse; Early outcome; Complication


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