Skip to main content
Erschienen in: Current Reviews in Musculoskeletal Medicine 1/2018

22.01.2018 | Rotator Cuff Repair (M Tao and M Teusink, section editors)

Massive Rotator Cuff Tear: When to Consider Reverse Shoulder Arthroplasty

verfasst von: Thomas R. Sellers, Adham Abdelfattah, Mark A. Frankle

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

The purpose of this review is to discuss the indications for reverse shoulder arthroplasty (RSA) in the treatment of massive rotator cuff tear (MCT), review the reported outcomes in the literature, and outline our approach and surgical technique for treating these patients.

Recent Findings

While RSA remains a successful and well-accepted treatment for cuff tear arthropathy (CTA), management of MCT in the absence of arthritis is controversial. In this particular setting, patients best suited for RSA are elderly, lower-demand individuals with chronic, irreparable MCT, and pseudoparalysis. Age < 60, better pre-operative function and upper extremity neurologic dysfunction are potential risk factors for poor outcome with RSA in this population. Long-term follow-up studies of RSA for CTA and MCT show good functional outcomes and implant survival > 90% at 10 years.

Summary

Treatment of MCT must be individualized for each patient. When patient selection is optimized, RSA is a reliable means of relieving pain and improving function with excellent success. Further investigation is necessary to better define its indications and assess the role of alternative, joint-salvaging procedures.
Literatur
5.
Zurück zum Zitat Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res. 1993;291:20–8. Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res. 1993;291:20–8.
7.
Zurück zum Zitat Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16(1):65–8.PubMed Grammont PM, Baulot E. Delta shoulder prosthesis for rotator cuff rupture. Orthopedics. 1993;16(1):65–8.PubMed
19.
Zurück zum Zitat Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87(8):1697–705. https://doi.org/10.2106/JBJS.D.02813.PubMed Frankle M, Siegal S, Pupello D, Saleem A, Mighell M, Vasey M. The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. A minimum two-year follow-up study of sixty patients. J Bone Joint Surg Am. 2005;87(8):1697–705. https://​doi.​org/​10.​2106/​JBJS.​D.​02813.PubMed
23.
Zurück zum Zitat Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990:92–6. Hamada K, Fukuda H, Mikasa M, Kobayashi Y. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res. 1990:92–6.
26.
Zurück zum Zitat Post M, Jablon M. Constrained total shoulder arthroplasty: long-term follow-up observations. Clin Orthop Relat Res. 1983;173:109–16. Post M, Jablon M. Constrained total shoulder arthroplasty: long-term follow-up observations. Clin Orthop Relat Res. 1983;173:109–16.
43.
Zurück zum Zitat Harreld KL, Puskas BL, Frankle M. Massive rotator cuff tears without arthropathy: when to consider reverse shoulder arthroplasty. J Bone Joint Surg Am. 2011;93(10):973–84.PubMed Harreld KL, Puskas BL, Frankle M. Massive rotator cuff tears without arthropathy: when to consider reverse shoulder arthroplasty. J Bone Joint Surg Am. 2011;93(10):973–84.PubMed
46.
Zurück zum Zitat • Samuelsen BT, Wagner ER, Houdek MT, Elhassan BT, Sanchez-Sotelo J, Cofield R, et al. Primary reverse shoulder arthroplasty in patients aged 65 years or younger. J Shoulder Elb Surg. 2017;26(1):e13–e17. This study reported outcomes after RSA in younger patients with CTA or severe glenohumeral arthritis and deemed it to be a viable option in this population. https://doi.org/10.1016/j.jse.2016.05.026.CrossRef • Samuelsen BT, Wagner ER, Houdek MT, Elhassan BT, Sanchez-Sotelo J, Cofield R, et al. Primary reverse shoulder arthroplasty in patients aged 65 years or younger. J Shoulder Elb Surg. 2017;26(1):e13–e17. This study reported outcomes after RSA in younger patients with CTA or severe glenohumeral arthritis and deemed it to be a viable option in this population. https://​doi.​org/​10.​1016/​j.​jse.​2016.​05.​026.CrossRef
48.
Zurück zum Zitat • Hartzler RU, Steen BM, Hussey MM, Cusick MC, Cottrell BJ, Clark RE, et al. Reverse shoulder arthroplasty for massive rotator cuff tear: risk factors for poor functional improvement. J Shoulder Elb Surg. 2015;24(11):1698–1706. Study evaluated patients undergoing RSA for massive cuff tear without osteoarthritis and identified pre-operative risk factors for worse outcomes. https://doi.org/10.1016/j.jse.2015.04.015.CrossRef • Hartzler RU, Steen BM, Hussey MM, Cusick MC, Cottrell BJ, Clark RE, et al. Reverse shoulder arthroplasty for massive rotator cuff tear: risk factors for poor functional improvement. J Shoulder Elb Surg. 2015;24(11):1698–1706. Study evaluated patients undergoing RSA for massive cuff tear without osteoarthritis and identified pre-operative risk factors for worse outcomes. https://​doi.​org/​10.​1016/​j.​jse.​2015.​04.​015.CrossRef
52.
Zurück zum Zitat • Shamsudin A, Lam PH, Peters K, Rubenis I, Hackett L, Murrell GA. Revision versus primary arthroscopic rotator cuff repair: a 2-year analysis of outcomes in 360 patients. Am J Sports Med. 2015;43(3):557–564. Study investigated the outcome differences between primary and revision rotator cuff repair surgery. https://doi.org/10.1177/0363546514560729.CrossRefPubMed • Shamsudin A, Lam PH, Peters K, Rubenis I, Hackett L, Murrell GA. Revision versus primary arthroscopic rotator cuff repair: a 2-year analysis of outcomes in 360 patients. Am J Sports Med. 2015;43(3):557–564. Study investigated the outcome differences between primary and revision rotator cuff repair surgery. https://​doi.​org/​10.​1177/​0363546514560729​.CrossRefPubMed
58.
62.
Zurück zum Zitat • Petrillo S, Longo UG, Papalia R, Denaro V. Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears and cuff tear arthropathy: a systematic review. Musculoskelet Surg. 2017;101(2):105–112. Study analyzed outcomes and complications of RSA for MCT and CTA in a large number of patients pooled from multiple studies. https://doi.org/10.1007/s12306-017-0474-z.CrossRefPubMed • Petrillo S, Longo UG, Papalia R, Denaro V. Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears and cuff tear arthropathy: a systematic review. Musculoskelet Surg. 2017;101(2):105–112. Study analyzed outcomes and complications of RSA for MCT and CTA in a large number of patients pooled from multiple studies. https://​doi.​org/​10.​1007/​s12306-017-0474-z.CrossRefPubMed
64.
Zurück zum Zitat • Black EM, Roberts SM, Siegel E, Yannopoulos P, Higgins LD, Warner JJ. Failure after reverse total shoulder arthroplasty: what is the success of component revision? J Shoulder Elb Surg. 2015;24(12):1908–1914. This study evaluated outcomes after revision RSA for failure. While pain relief and functional improvement can be achieved, complication and re-operation rates are high. https://doi.org/10.1016/j.jse.2015.05.029.CrossRef • Black EM, Roberts SM, Siegel E, Yannopoulos P, Higgins LD, Warner JJ. Failure after reverse total shoulder arthroplasty: what is the success of component revision? J Shoulder Elb Surg. 2015;24(12):1908–1914. This study evaluated outcomes after revision RSA for failure. While pain relief and functional improvement can be achieved, complication and re-operation rates are high. https://​doi.​org/​10.​1016/​j.​jse.​2015.​05.​029.CrossRef
67.
69.
Zurück zum Zitat • Cuff DJ, Pupello DR, Santoni BG, Clark RE, Frankle MA. Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency: a concise follow-up, at a minimum of 10 years, of previous reports. J Bone Joint Surg Am. 2018. Study reports outcomes and implant survival of RSA after a minimum of 10 years. • Cuff DJ, Pupello DR, Santoni BG, Clark RE, Frankle MA. Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency: a concise follow-up, at a minimum of 10 years, of previous reports. J Bone Joint Surg Am. 2018. Study reports outcomes and implant survival of RSA after a minimum of 10 years.
71.
Zurück zum Zitat • Makhni EC, Swart E, Steinhaus ME, Mather RC 3rd, Levine WN, Bach BR Jr, et al. Cost-effectiveness of reverse total shoulder arthroplasty versus arthroscopic rotator cuff repair for symptomatic large and massive rotator cuff tears. Arthroscopy. 2016;32(9):1771–1780. Study examined cost considerations for RSA and RCR in the treatment of large and massive cuff tears. https://doi.org/10.1016/j.arthro.2016.01.063.CrossRefPubMed • Makhni EC, Swart E, Steinhaus ME, Mather RC 3rd, Levine WN, Bach BR Jr, et al. Cost-effectiveness of reverse total shoulder arthroplasty versus arthroscopic rotator cuff repair for symptomatic large and massive rotator cuff tears. Arthroscopy. 2016;32(9):1771–1780. Study examined cost considerations for RSA and RCR in the treatment of large and massive cuff tears. https://​doi.​org/​10.​1016/​j.​arthro.​2016.​01.​063.CrossRefPubMed
72.
Zurück zum Zitat • Henry P, Wasserstein D, Park S, Dwyer T, Chahal J, Slobogean G, et al. Arthroscopic repair for chronic massive rotator cuff tears: a systematic review. Arthroscopy. 2015;31(12):2472–2480. This review evaluated outcomes after arthroscopic rotator cuff repair for massive cuff tear in a large number of patients pooled from multiple studies. https://doi.org/10.1016/j.arthro.2015.06.038.CrossRefPubMed • Henry P, Wasserstein D, Park S, Dwyer T, Chahal J, Slobogean G, et al. Arthroscopic repair for chronic massive rotator cuff tears: a systematic review. Arthroscopy. 2015;31(12):2472–2480. This review evaluated outcomes after arthroscopic rotator cuff repair for massive cuff tear in a large number of patients pooled from multiple studies. https://​doi.​org/​10.​1016/​j.​arthro.​2015.​06.​038.CrossRefPubMed
74.
Zurück zum Zitat • Namdari S, Donegan RP, Chamberlain AM, Galatz LM, Yamaguchi K, Keener JD. Factors affecting outcome after structural failure of repaired rotator cuff tears. J Bone Joint Surg Am. 2014;96(2):99–105. This study demonstrated successful outcomes in 54% of patients after RCR despite failure of structural healing of the repair. https://doi.org/10.2106/JBJS.M.00551.CrossRefPubMed • Namdari S, Donegan RP, Chamberlain AM, Galatz LM, Yamaguchi K, Keener JD. Factors affecting outcome after structural failure of repaired rotator cuff tears. J Bone Joint Surg Am. 2014;96(2):99–105. This study demonstrated successful outcomes in 54% of patients after RCR despite failure of structural healing of the repair. https://​doi.​org/​10.​2106/​JBJS.​M.​00551.CrossRefPubMed
Metadaten
Titel
Massive Rotator Cuff Tear: When to Consider Reverse Shoulder Arthroplasty
verfasst von
Thomas R. Sellers
Adham Abdelfattah
Mark A. Frankle
Publikationsdatum
22.01.2018
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 1/2018
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-018-9467-2

Weitere Artikel der Ausgabe 1/2018

Current Reviews in Musculoskeletal Medicine 1/2018 Zur Ausgabe

Rotator Cuff Repair (M Tao and M Teusink, section editors)

Rotator cuff repair: post-operative rehabilitation concepts

Rotator Cuff Repair (M Tao and M Teusink, section editors)

The Role of Tendon Transfers for Irreparable Rotator Cuff Tears

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Injury Prevention in Baseball: from Youth to the Pros

Rotator Cuff Repair (M Tao and M Teusink, section editors)

The Role of Biologic Therapy in Rotator Cuff Tears and Repairs

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.