Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair.
Patient reported outcomes
Reverse total shoulder arthroplasty
Subscapularis repair
Journal
JSES international
ISSN: 2666-6383
Titre abrégé: JSES Int
Pays: United States
ID NLM: 101763461
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
entrez:
10
11
2022
pubmed:
11
11
2022
medline:
11
11
2022
Statut:
epublish
Résumé
In performing reverse total shoulder arthroplasty (rTSA), the role of repairing the subscapularis has been debated. Our objective was to determine the effect of subscapularis repair following rTSA on postoperative shoulder ranges of motion and patient reported outcome scores (PROs). A prospective registry was reviewed to establish a cohort of primary rTSA patients with a 135-degree humeral implant, with a minimum of 2 years of follow-up. Variables collected included demographics, subscapularis repair information, diagnosis, glenosphere size, and glenoid lateralization information. Outcomes collected were range of motion measurements, subscapularis strength, and multiple generic and shoulder PROs. Multivariable linear regression models were created to predict these 2-year outcomes. The 143-patient cohort had a mean age of 69 years with 68% of patients undergoing subscapularis repair. After adjustment in the multivariable models, whether the subscapularis was repaired did not significantly predict a 2-year forward elevation, external rotation, internal rotation, subscapularis strength, Western Ontario Osteoarthritis of the Shoulder score, VR-12 scores, Constant Score, or American Shoulder and Elbow Surgeons Shoulder Scores. Increased glenoid lateralization significantly predicted greater internal rotation, higher VR-12 physical score, and higher Constant Score. There were no dislocations in either group. After adjusting for patient and implant factors, subscapularis repair was not associated with a 2-year postoperative range of motion, strength, or any PROs suggesting that repairing the subscapularis may not affect functional outcome. Increased glenoid lateralization through the baseplate and glenosphere independently predicted better internal rotation, VR-12 physical score, and Constant Scores indicating a benefit to lateralization during rTSA.
Sections du résumé
Background
UNASSIGNED
In performing reverse total shoulder arthroplasty (rTSA), the role of repairing the subscapularis has been debated. Our objective was to determine the effect of subscapularis repair following rTSA on postoperative shoulder ranges of motion and patient reported outcome scores (PROs).
Methods
UNASSIGNED
A prospective registry was reviewed to establish a cohort of primary rTSA patients with a 135-degree humeral implant, with a minimum of 2 years of follow-up. Variables collected included demographics, subscapularis repair information, diagnosis, glenosphere size, and glenoid lateralization information. Outcomes collected were range of motion measurements, subscapularis strength, and multiple generic and shoulder PROs. Multivariable linear regression models were created to predict these 2-year outcomes.
Results
UNASSIGNED
The 143-patient cohort had a mean age of 69 years with 68% of patients undergoing subscapularis repair. After adjustment in the multivariable models, whether the subscapularis was repaired did not significantly predict a 2-year forward elevation, external rotation, internal rotation, subscapularis strength, Western Ontario Osteoarthritis of the Shoulder score, VR-12 scores, Constant Score, or American Shoulder and Elbow Surgeons Shoulder Scores. Increased glenoid lateralization significantly predicted greater internal rotation, higher VR-12 physical score, and higher Constant Score. There were no dislocations in either group.
Conclusions
UNASSIGNED
After adjusting for patient and implant factors, subscapularis repair was not associated with a 2-year postoperative range of motion, strength, or any PROs suggesting that repairing the subscapularis may not affect functional outcome. Increased glenoid lateralization through the baseplate and glenosphere independently predicted better internal rotation, VR-12 physical score, and Constant Scores indicating a benefit to lateralization during rTSA.
Identifiants
pubmed: 36353412
doi: 10.1016/j.jseint.2022.07.009
pii: S2666-6383(22)00151-7
pmc: PMC9637760
doi:
Types de publication
Journal Article
Langues
eng
Pagination
923-928Informations de copyright
© 2022 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.
Références
J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):892-6
pubmed: 19282204
J Bone Joint Surg Am. 2007 Jul;89(7):1476-85
pubmed: 17606786
Bull Hosp Jt Dis (2013). 2015 Dec;73 Suppl 1:S21-7
pubmed: 26631191
J Shoulder Elbow Surg. 2017 Mar;26(3):450-457
pubmed: 27751722
J Shoulder Elbow Surg. 2003 Nov-Dec;12(6):622-7
pubmed: 14671531
J Ambul Care Manage. 2006 Oct-Dec;29(4):310-9
pubmed: 16985389
Arch Orthop Trauma Surg. 2021 Jul 8;:
pubmed: 34236460
JB JS Open Access. 2018 Jul 12;3(3):e0056
pubmed: 30533594
J Shoulder Elbow Surg. 2014 Aug;23(8):1091-8
pubmed: 24480326
J Am Acad Orthop Surg. 2018 Mar 1;26(5):e114-e119
pubmed: 29419724
Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S174-88
pubmed: 22588743
Musculoskelet Surg. 2016 Aug;100(2):121-6
pubmed: 26984229
J Shoulder Elbow Surg. 1994 Nov;3(6):347-52
pubmed: 22958838
J Shoulder Elbow Surg. 2021 Nov;30(11):2498-2505
pubmed: 33753271
Qual Life Res. 2009 Feb;18(1):43-52
pubmed: 19051059
J Orthop. 2020 Mar 27;22:64-67
pubmed: 32280171
J Shoulder Elbow Surg. 2018 Nov;27(11):1946-1952
pubmed: 29934280
J Shoulder Elbow Surg. 2017 Apr;26(4):662-668
pubmed: 28277259
J Shoulder Elbow Surg. 2007 Jul-Aug;16(4):403-7
pubmed: 17363294
Int Orthop. 2019 Nov;43(11):2579-2586
pubmed: 30612172
J Shoulder Elbow Surg. 2008 Mar-Apr;17(2):355-61
pubmed: 18218327
Clin Orthop Relat Res. 1987 Jan;(214):160-4
pubmed: 3791738
Arthroscopy. 2003 Dec;19(10):1109-20
pubmed: 14673454
J Shoulder Elbow Surg. 2021 May;30(5):1159-1166
pubmed: 32858194
J Am Acad Orthop Surg. 2021 Jul 15;29(14):604-608
pubmed: 34014848
Arch Orthop Trauma Surg. 2022 Sep;142(9):2147-2156
pubmed: 33635398
Osteoarthritis Cartilage. 2001 Nov;9(8):771-8
pubmed: 11795997