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Does preoperative forward elevation weakness affect clinical outcomes in anatomic or reverse total shoulder arthroplasty patients with glenohumeral osteoarthritis and intact rotator cuff?
Hones, Keegan M; Hao, Kevin A; Buchanan, Timothy R; Trammell, Amy P; Wright, Jonathan O; Wright, Thomas W; LaMonica, Tyler J; Schoch, Bradley S; King, Joseph J.
Afiliación
  • Hones KM; Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
  • Hao KA; College of Medicine, University of Florida, Gainesville, FL, USA.
  • Buchanan TR; College of Medicine, University of Florida, Gainesville, FL, USA.
  • Trammell AP; Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
  • Wright JO; Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
  • Wright TW; Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
  • LaMonica TJ; Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
  • Schoch BS; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA.
  • King JJ; Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
Clin Shoulder Elb ; 27(3): 316-326, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39138944
ABSTRACT

BACKGROUND:

This study sought to determine if preoperative forward elevation (FE) weakness affects outcomes of anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA) for patients with rotator cuff-intact glenohumeral osteoarthritis (RCI-GHOA).

METHODS:

A retrospective review of a single institution's prospectively collected shoulder arthroplasty database was performed between 2007 and 2020, including 333 aTSAs and 155 rTSAs for primary RCI-GHOA with a minimum 2-year follow-up. Defining preoperative weakness as FE strength ≤4.9 lb (2.2 kg), three cohorts were matched 111 by age, sex, and follow-up weak (n=82) to normal aTSAs, weak (n=44) to normal rTSAs, and weak aTSAs (n=61) to weak rTSAs. Compared outcomes included range of motion, outcome scores, and complication and revision rates at latest follow-up.

RESULTS:

Weak aTSAs and weak rTSAs achieved similar postoperative outcome measures to normal aTSAs and normal rTSAs, respectively (P>0.05). Compared to weak rTSAs, weak aTSAs achieved superior postoperative passive (P=0.006) and active external rotation (ER) (P=0.014) but less favorable postoperative Shoulder Pain and Disability Index (P=0.032), American Shoulder and Elbow Surgeons (P=0.024), and University of California, Los Angeles scores (P=0.008). Weak aTSAs achieved the minimal clinically important difference and substantial clinical benefit at a lower rate for abduction (P=0.045 and P=0.003) and FE (P=0.011 and P=0.001). Weak aTSAs had a higher revision rate (P=0.025) but a similar complication rate (P=0.291) compared to weak rTSAs.

CONCLUSIONS:

Patients with RCI-GHOA and preoperative FE weakness obtain postoperative outcomes similar to patients with normal preoperative strength after either aTSA or rTSA. Preoperatively, weak aTSAs achieved greater ER but lower rates of clinically relevant improvement in overhead motion compared to weak rTSAs. Level of evidence III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Shoulder Elb Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Corea del Sur
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Shoulder Elb Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Corea del Sur