Clinical Outcomes After Reverse Shoulder Arthroplasty With and Without Subscapularis Repair: The Importance of Considering Glenosphere Lateralization. Issue 5 (1st March 2018)

• Record Type: Journal Article
• Authors: Werner, Brian C.; Wong, Alexandra C.; Mahony, Gregory T.; Craig, Edward V.; Dines, David M.; Warren, Russell F.; Gulotta, Lawrence V.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 26:Issue 5(2018)
• Publication Date: 2018-03-01
• Subjects: reverse total shoulder arthroplasty -- subscapularis repair -- glenosphere lateralization -- American Shoulder and Elbow Surgeons shoulder score -- ASES score -- clinical outcome -- rotator cuff tear arthropathy -- glenohumeral osteoarthritis; Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-16-00781
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Introduction: Recent biomechanical data suggests that repairing the subscapularis during reverse shoulder arthroplasty (RSA) can increase the force required by the posterior rotator cuff and deltoid to elevate the arm. Methods: We retrospectively studied patients who underwent primary RSA and had baseline and minimum 2-year postoperative American Shoulder and Elbow Surgeons (ASES) shoulder scores, stratified them according to subscapularis management, then subgrouped them according to lateralization of the glenosphere component. Results: Patients with subscapularis repair and a lateralized glenosphere had significantly less improvement in ASES scores than did those without lateralization ( P = 0.016) and patients without subscapularis repair ( P = 0.006). Individually, subscapularis management ( P = 0.163) and glenosphere lateralization ( P = 0.847) had no significant effect on the change in ASES score but in combination did have a significant effect on the change in ASES score ( P = 0.002). Discussion: The combination of subscapularis repair and glenosphere implant lateralization in RSA translates to significantly less clinical improvement. Conclusions: Patients who underwent both subscapularis repair and glenosphere lateralization had significantly less improvement in ASES scores. Level of Evidence: Level III