DOI QR코드

DOI QR Code

Patients' Satisfaction after Reverse Total Shoulder Arthroplasty Is Affected by Preoperative Functional Status

  • Yoon, Jong Pil (Department of Orthopedic Surgery, Kyungpook University School of Medicine) ;
  • Kim, Dong-Hyun (Department of Orthopedic Surgery, Kyungpook University School of Medicine) ;
  • Chung, Seok Won (Department of Orthopedic Surgery, Konkuk University School of Medicine)
  • Received : 2015.09.17
  • Accepted : 2015.11.30
  • Published : 2016.09.30

Abstract

Background: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. Methods: Forty-three patients (mean age, $75.0{\pm}5.2years$) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. Results: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. Conclusions: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.

Keywords

References

  1. Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16(1):65-8.
  2. Boileau P, Watkinson DJ, Hatzidakis AM, Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14(1 Suppl S):147S-61S. https://doi.org/10.1016/j.jse.2004.10.006
  3. Werner CM, Steinmann PA, Gilbart M, Gerber C. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am. 2005;87(7):1476-86.
  4. Mole D, Favard L. Excentered scapulohumeral osteoarthritis. Rev Chir Orthop Reparatrice Appar Mot. 2007;93(6 Suppl): 37-94.
  5. Muh SJ, Streit JJ, Wanner JP, et al. Early follow-up of reverse total shoulder arthroplasty in patients sixty years of age or younger. J Bone Joint Surg Am. 2013;95(20):1877-83. https://doi.org/10.2106/JBJS.L.10005
  6. Beck JD, Irgit KS, Andreychik CM, Maloney PJ, Tang X, Harter GD. Reverse total shoulder arthroplasty in obese patients. J Hand Surg Am. 2013;38(5):965-70. https://doi.org/10.1016/j.jhsa.2013.02.025
  7. Simovitch RW, Helmy N, Zumstein MA, Gerber C. Impact of fatty infiltration of the teres minor muscle on the outcome of reverse total shoulder arthroplasty. J Bone Joint Surg Am. 2007;89(5):934-9. https://doi.org/10.2106/JBJS.F.01075
  8. Ek ET, Neukom L, Catanzaro S, Gerber C. Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years. J Shoulder Elbow Surg. 2013;22(9):1199-208. https://doi.org/10.1016/j.jse.2012.11.016
  9. Kasten P, Maier M, Rettig O, Raiss P, Wolf S, Loew M. Proprioception in total, hemi-and reverse shoulder arthroplasty in 3D motion analyses: a prospective study. Int Orthop. 2009;33(6):1641-7. https://doi.org/10.1007/s00264-008-0666-0
  10. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990;(254):92-6.
  11. Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Mole D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff. Results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004;86(3):388-95. https://doi.org/10.1302/0301-620X.86B3.14024
  12. De Wilde L, Audenaert E, Barbaix E, Audenaert A, Soudan K. Consequences of deltoid muscle elongation on deltoid muscle performance: a computerised study. Clin Biomech (Bristol, Avon). 2002;17(7):499-505. https://doi.org/10.1016/S0268-0033(02)00065-7
  13. Jobin CM, Brown GD, Bahu MJ, et al. Reverse total shoulder arthroplasty for cuff tear arthropathy: the clinical effect of deltoid lengthening and center of rotation medialization. J Shoulder Elbow Surg. 2012;21(10):1269-77. https://doi.org/10.1016/j.jse.2011.08.049
  14. Chung SW, Kim JY, Kim MH, Kim SH, Oh JH. Arthroscopic repair of massive rotator cuff tears: outcome and analysis of factors associated with healing failure or poor postoperative function. Am J Sports Med. 2013;41(7):1674-83. https://doi.org/10.1177/0363546513485719
  15. Oh JH, Kim SH, Shin SH, et al. Outcome of rotator cuff repair in large-to-massive tear with pseudoparalysis: a comparative study with propensity score matching. Am J Sports Med. 2011; 39(7):1413-20. https://doi.org/10.1177/0363546511399865
  16. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre-and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;(304):78-83.
  17. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg. 1999;8(6):599-605. https://doi.org/10.1016/S1058-2746(99)90097-6
  18. Nyffeler RW, Werner CM, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg. 2005;14(5):524-8. https://doi.org/10.1016/j.jse.2004.09.010
  19. Young AA, Smith MM, Bacle G, Moraga C, Walch G. Early results of reverse shoulder arthroplasty in patients with rheumatoid arthritis. J Bone Joint Surg Am. 2011;93(20):1915-23. https://doi.org/10.2106/JBJS.J.00300