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Outcomes of RSA: Review of Literature

  • Daniele Passaretti
  • Vittorio Candela
  • Stefano Gumina
Chapter

Abstract

The original indications for reverse shoulder arthroplasty (RSA) were the cuff tear arthropathy, anatomic total shoulder arthroplasty failure, and tumor reconstruction. However, the increasingly widespread use of the RSA leads shoulder surgeons to implant RSA in case of severe proximal humerus fractures, shoulder pseudoparalysis, and massive irreparable rotator cuff tear in absence of cuff arthropathy.

A recent study analyzed the long-term outcomes of the RSA, with a minimum and mean follow-up of 10 and 12.5 years, respectively. The authors considered 87 implants and concluded that despite a high arthroplasty survival rate and good long-term clinical results, RSA outcomes showed deterioration when compared with medium-term results. The cause of this decrease is probably related to patient aging coupled with bone erosion and/or deltoid impairment over time. In detail, the mean age at the time of surgery was 72.7 years, and Grammont-designed prostheses were used in all patients. At last follow-up, mean absolute and relative Constant-Murley scores (and standard deviations) were 55 ± 16 points and 86 ± 26 points, respectively. Both scores remained acceptable but have decreased significantly compared with the scores at the medium-term follow-up, at a minimum of 2 years (63 ± 14 and 90 ± 21 points, respectively), except for the pain subgroup score. Similarly, anterior active elevation improved significantly after prosthesis implantation but decreased significantly between the medium and long-term follow-up evaluations (138° and 131°, respectively).

Keywords

Reverse shoulder replacement results Clinical outcomes of reverse shoulder arthroplasty Outcomes following reverse shoulder arthroplasty Shoulder arthroplasty results 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Daniele Passaretti
    • 1
    • 2
  • Vittorio Candela
    • 1
    • 2
  • Stefano Gumina
    • 3
  1. 1.Department of Anatomy, Histology, Legal Medicine and OrthopedicsSapienza, University of RomeRomeItaly
  2. 2.Istituto Chirurgico Ortopedico Traumatologico (ICOT)LatinaItaly
  3. 3.Department of Orthopaedics and TraumatologySapienza University of RomeRomeItaly

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