Reverse Shoulder Arthroplasty is Superior to Hemiarthroplasty for Cuff Tear Arthropathy with Preserved Motion
BackgroundIt is unclear whether hemiarthroplasty (HA) or reverse shoulder arthroplasty (RS) are superior for patientswith cuff tear arthropathy (CTA) and preserved preoperative motion (elevation >90˚).
MethodsThis was a retrospective, single institution study. Patients who underwent RSA or HA for CTA were included ifthey had preserved preoperative motion with a minimum of 2 years of follow-up, or until complication/revision. ShoulderROM and functional outcomes scores were obtained.
ResultsTwenty-six HAs and 21 RSAs were evaluated at mean of 38.6 months (HA) and 36.3 months (RSA). Patientsin the RSA group were significantly older at surgery (73.9 versus 65.1 years; P=0.003). Postoperatively, the meanchange in active elevation was -15° for HA versus 26° for RSA, with RSA having significantly greater active elevation(153° versus 123°; P=0.01). There were no significant differences in final internal or external rotation between groups.Superior outcomes were seen for RSA versus HA for ASES score (84 vs. 66, P=0.003), Simple Shoulder Test (8.8 vs.7.3, P=0.3), Single Assessment Numeric Evaluation (85 vs. 70, P=0.017), and 100mm VAS pain (7 vs. 33, P<0.001).
ConclusionIn patients with CTA and preserved preoperative forward elevation, RSA provided greater pain relief,superior functional outcomes, and better ROM compared with HA.Level of evidence: IV
Archives of Bone and Joint Surgery , Volume:8 Issue:1, 2020
75 - 82
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