Outcomes of reverse total shoulder arthroplasty are similar in rotator cuff-intact and rotator cuff-deficient shoulders

Abstract

BackgroundControversy exists regarding the biomechanical and clinical effects of reverse total shoulder arthroplasty (RTSA) in shoulders with an intact versus a torn rotator cuff (RC). We compared clinical and radiographic outcomes at a minimum of 2 years after RTSA for cuff-intact or cuff-deficient conditions. MethodsRetrospective review identified 182 patients with at least 2 years of follow-up: 32 with an intact rotator cuff but advanced glenoid bone loss and 150 with a torn rotator cuff. Revision arthroplasties and those for osteonecrosis or trauma were excluded, and a matched cohort was created to compare 32 cuff-intact to 32 cuff-deficient shoulders. Assessments included preoperative and postoperative visual analog pain scores (VAS), American Shoulder and Elbow Surgeons (ASES) scores, narcotic use, strength, range of motion (ROM), complications, and revisions. Radiographs were analyzed for signs of loosening or mechanical failure. ResultsMean age for all patients was 71.7 (61-82) years, and the mean follow-up was 2.7 (2.0-5.5) years. Preoperatively, the groups were similar in almost every functional preoperative category, with no differences in gender, laterality, age, preoperative narcotic use, body mass index, or other co-morbidities. Postoperatively, no significant differences were found regarding VAS pain, ASES, ROM, strength, complication rate, revision rate, narcotic use, implant loosening, or mechanical failure; both groups showed significant improvements in all categories measured. ConclusionsRTSA provides reliably good functional and radiographic outcomes with low complication rates in indicated patients, regardless of the preoperative status of the rotator cuff. Level of evidenceLevel III; Retrospective Comparative Study