Does indication matter in the functional outcome of reverse shoulder arthroplasty? - A comparative retrospective study

Abstract

Reverse Shoulder Arthroplasty is done for Cuff Tear Arthropathy (CTA) and other indications. We hypothesize that CTA patients and patients with other indications will have differing functional outcome following RSA. We retrospectively studied 23 patients treated in our center between 2014 and 2017. The patients who were aged 60 and above with normal Deltoid function, normal cognition and a minimum follow-up of 12 months were included. Of the 23 patients, 16 had CTA and 7 had either a complex fracture dislocation, arthritis with malunion, excision arthroplasty or a chronic dislocation. We compared the functional outcome using Constant Shoulder Score at a mean follow up of 24.6 months. The post-operative scores were significantly higher in the CTA group, but the magnitude of functional improvement from preoperative status following RSA was either comparable (absolute change) or even better (percentage change) in non-CTA patients compared to CTA patients. There were no significant differences in the complication rates between the two groups. We conclude that one should not be discouraged by the lower values of functional scores in RSA done for non-CTA indications and be aware that the functional improvement following RSA in such complex cases is encouragingly better than that following RSA in CTA.