Intermediate and long-term follow-up of total shoulder arthroplasty for the management of postcapsulorrhaphy arthropathy

Abstract

The purpose of this study was to evaluate the subjective and objective outcomes in patients undergoing total shoulder arthroplasty for treatment of postcapsulorrhaphy arthropathy (CA) and compare them with outcomes in patients undergoing total shoulder arthroplasty for primary glenohumeral osteoarthritis (OA). Total shoulder arthroplasty was used to treat 25 consecutive CA patients (25 shoulders) at our institution; of these, 22 patients were available for follow-up. An age-matched cohort of 19 consecutive patients (20 shoulders) who were treated with total shoulder arthroplasty for primary glenohumeral OA was compared with the CA group. Patients were evaluated by physical examination and patient outcome measures (American Shoulder and Elbow Surgeons assessment and Simple Shoulder Test). Complications, reoperations, and subscapularis function was also recorded. Compared with the CA group, the OA group achieved greater forward elevation (165° vs 147°; P = .036) and greater external rotation (56° vs. 45°; P = .04); however, no significant differences were seen in subjective patient scores between the 2 groups for Simple Shoulder Test (P = .90), American Shoulder and Elbow Surgeons assessment (P = .65), and pain scores (P = .80). The difference in the number of revision surgeries in the OA group compared with the CA group (1 vs 4) was not significant (P = .35). A significantly higher number of patients in the CA group had subscapularis insufficiency compared with the OA group (5 CA vs 0 OA; P = .049). Our findings suggest that when compared with patients undergoing total shoulder arthroplasty for primary OA, CA patients experience similar outcomes with respect to revision surgery, pain relief, and subjective self-assessment and have a higher incidence of subscapularis insufficiency.