Clinical outcomes of reverse total shoulder arthroplasty (RTSA)

Abstract

Patients who have been diagnosed with glenohumeral arthritis due to inflammatory, degenerative and traumatic causes usually have a progressive course of disease and is very often not controlled with medication and conservative treatment. Most patients eventually end up with disabling pain, dysfunction and limited mobility requiring surgical intervention. Few treatment options are available when it comes to surgical intervention. These primarily include anatomical shoulder arthroplasty hemiarthroplasty and the more recent reverse total shoulder arthroplasty. Although approved by the United States Food and Drug Administration (FDA) in 2004, reverse total shoulder arthroplasty (RSA) has recently become popular worldwide as a treatment of choice for glenohumeral arthritis with promising outcomes and minimal complications. Reverse Total Shoulder Arthroplasty (RTSA) is indicated for variety of shoulder conditions that involve a loss of rotator cuff function or massive tears, inflammatory pathology, gleno humeral arthritis complex proximal humerus trauma and other pathologies that cannot be effectively treated with traditional shoulder arthroplasty. RTSA can restore shoulder function and alleviate pain in these individuals. The goal of this study confirms previously reported improvements in pain, function scores, and range of motion, in patients treated with RTSA and to record clinical outcomes in Asian population.To evaluate the clinical outcomes of patients undergoing reverse total shoulder arthroplasty (RTSA). The present study was undertaken as a prospective, observational study among 30 Patients undergoing RTSA for various indications and attending the study hospital for medical care. The deltopectoral surgical approach was used on all participant placed in the beach chair position. Patients were followed up for 1 year postoperatively to asses outcome of RTSA. Study showed participants were elderly(>60yrs) and female predominance. Mean body weight of participants was 57.37 ±4.25 kg, (95%CI 55.78-58.96 kg). Among 19 (63.3%) participants affected hand was right, 10 (33.3%) had left hand and 1 (3.3%) had bilateral limb affected. Study demonstrated significant improvements in all clinical outcomes measured using Constant Murley, ASES, SANE, SST scores and pain relief following shoulder surgery (p<0.05). The study demonstrated significant improvements in functional outcomes and pain relief following shoulder surgery. The Constant Murley, ASES, SANE, and SST scores all showed consistent and substantial enhancement from preoperative to multiple postoperative time points, up to 1 year. Pain reduction was evident with a decrease in the VAS score.