Reverse shoulder arthroplasty for irreparable massive rotator cuff tears: a systematic review with meta-analysis and meta-regression

Sevivas, Nuno; Ferreira, Nuno; Andrade, Renato; Moreira, Pedro Silva; Portugal, Raquel; Alves, D.; Silva, Manuel Vieira da; Sousa, Nuno; Salgado, António J.; Espregueira-Mendes, João

doi:10.1016/j.jse.2017.03.039

Cited by 111 publications

(55 citation statements)

References 64 publications

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“…Transfers or palliative options (tenotomy or tenodesis of a long head of biceps still present) [43] could be discussed but have the same limitations. RSA, in these difficult situations, is a reasonable option to relieve pain and restore function [111][112][113] .…”

Section: Indications Of Rsa In Mct Without Glenohumeral Arthritismentioning

confidence: 99%

“…While multiple reports have shown RSA to be a reliable procedure with good outcomes in patients less than 65 years of age [65,111,112] , Muh et al reported that patient satisfaction was lower for younger patients [111] . Hartzler et al [69] recently found younger age to be a risk factor for poor functional improvement after RSA in the specific setting of MCT without arthritis.…”

Section: Agementioning

confidence: 99%

“…Sevivas et al [112] in 2017 performed a comprehensive search on the databases. 6 studies including 266 shoulders were included with a follow up from 34 to 61 months.…”

Section: Functionmentioning

confidence: 99%

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Reverse Shoulder Arthroplasty for Massive Rotator Cuff Tears

Oudet¹

2019

International Journal of Orthopaedics

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The purpose of this review is to explore, the role of reverse shoulder arthroplasty (RSA) in substituting cuff dysfunction, indications, reported outcomes in the literature and surgical technique for treating patients with massive cuff tear (MCT) without gleno-humeral arthritis. Undoubtedly, the RSA is a well-accepted treatment for cuff tear arthropathy, but is there a place for a prosthesis to treat a tendinous disease? Moreover, if there is no debate to implant an RSA in an elderly, low-demand patient with a massive, retracted, irreparable cuff tear, what is the place of RSA in a young, active patient with an acceptable preoperative function when there is no other treatment? Young age and good preop function are debatable indications for RSA despite good and sustainable results at ten years of follow up. So, treatment of MCT must be adapted to each situation. RSA is not for everybody and there is a place for other treatments. When the indication is well selected and the technique precise, RSA provides, in a large majority of patients, a pain-free, improved shoulder with durable results.

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Section: Indications Of Rsa In Mct Without Glenohumeral Arthritismentioning

confidence: 99%

Section: Agementioning

confidence: 99%

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Reverse Shoulder Arthroplasty for Massive Rotator Cuff Tears

Oudet¹

2019

International Journal of Orthopaedics

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“…In massive irreparable rotator cuff tears, several treatment options include arthroscopic debridement, partial repair, [1][2][3] superior capsular reconstruction (SCR), [4][5][6] auto-or allograft interposition, 7) balloon spacer arthroplasty, [8][9][10] trapezius transfer, and latissimus dorsi (LD) transfer 11) or reverse total shoulder arthroplasty (RTSA). [12][13][14][15] Arthroscopic debridement provides pain relief by removing the damaged torn rotator cuff tissue. In partial repair, an attempt is made to repair as much cuff as possible.…”

Section: Introductionmentioning

confidence: 99%

“…Balloon spacer arthroplasty has recently been proposed, and acts by preventing humeral head migration by placing a biodegradable saline-filled spacer between the humeral head and acromion; however, there is no long-term follow-up study to determine the outcome. [8][9][10] Also, RTSA is very effective for irreparable rotator cuff tears in elderly patients, [12][13][14][15] but due to the questionable longevity of RTSA and limited treatment options after failure, this procedure is not an ideal option for young, active patients. In the future, long term follow-up studies that compare different treatment modalities are required, to verify the superiority of a specific procedure and to determine patient specific indications.…”

Section: Introductionmentioning

confidence: 99%

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

Suh

Tankshali

et al. 2019

Clin Shoulder Elbow

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Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up.Methods: From November 2008 to December 2016, 23 patients (57.5 ± 4.4 years; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was 4.7 ± 4.0 years (range, 2?12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated.Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last follow-up (<i>p</i><0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (<i>p</i>=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study.Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

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