Outcomes of total shoulder arthroplasty for instability arthropathy with a prior coracoid transfer procedure: a retrospective review and matched cohort

Impact of prior anterior instability on shoulder arthroplasty outcomes: a systematic review

“…1 ). Of the included studies, 9 were considered level of evidence III, 2 , 3 , 7 , 10 , 15 , 26 , 27 , 29 , 34 with the remaining 7 being level of evidence IV. 8 , 9 , 14 , 21 , 37 , 40 , 42

Figure 1 Flow diagram displaying the systematic review of search strategy.

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“…Of the included studies, 5 studies utilized an anatomic implant, 2 , 3 , 7 , 26 , 29 4 studies utilized an rTSA implant, 8 , 9 , 15 , 37 4 studies utilized either a HA or an anatomic TSA implant, 14 , 21 , 27 , 40 2 utilized either a rTSA or an anatomic TSA implant, 10 , 34 and 1 study utilized all 3 implant types (TSA, rTSA, and HA). 42 Twelve studies specifically commented on their surgical approach, with 9 using a deltopectoral approach.…”

“… 42 Twelve studies specifically commented on their surgical approach, with 9 using a deltopectoral approach. 2 , 3 , 10 , 14 , 21 , 27 , 34 , 37 , 42 The other 3 studies utilized a combination of anterosuperior or anteromedial approaches, with the majority of cases still being done through a deltopectoral approach. 7 , 9 , 40 Ten studies discussed handling of the subscapularis, which was either repaired or tenotomized in all studies, except in cases of tendon ruptures/tears.…”

“… 7 , 9 , 40 Ten studies discussed handling of the subscapularis, which was either repaired or tenotomized in all studies, except in cases of tendon ruptures/tears. 2 , 3 , 7 , 10 , 14 , 15 , 21 , 34 , 37 , 42 Number of subscapularis repairs vs. tenotomies were not specified in any of the included studies. Indications for anatomic TSA included capsulorrhaphy arthropathy and degenerative GHOA, while indications for rTSA included an irreparable, massive tear of the rotator cuff, rupture of the subscapularis tendon, or an isolated fatty infiltration of the subscapularis muscle, following failed prior instability management (operative or nonoperative).…”

“…Results are largely comparable. 5 Early complication rates following total shoulder arthroplasty for instability arthropathy with prior coracoid transfer procedure 3 3 56 (52:4) 14 TSA ∗ vs. 42 TSA † Control Study: 56.7 ± 4.2 Control: 57.1 ± 5.0 Retrospective matched cohort study Prior coracoid transfer and subsequent TSA Rotator cuff tears, fixed dislocations, post shoulder instability, prior glenoid bone grafting from sources other than coracoid, HA, rTSA Study:58 ± 35 mo Control: 42 ± 28 mo - No significant difference in complications rates between study and control group; All patients significantly increased functional and PROs. 6 Intermediate and long-term follow-up of total shoulder arthroplasty for the management of postcapsulorrhaphy arthropathy 7 3 44 (45 shoulders) (34:9) 25 TSA ∗ vs. 19 TSA † Control Study: 55 ± 13 Control: 58 ± 12 Retrospective matched cohort study Patients with post-CA treated with TSA - Study: (24-136) mo Control: (24-72) mo Postcapsulorrhaphy TSA after CA helps with pain and function but have worse outcomes compared to TSA for OA.…”