2019 ISAKOS Biennial Congress ePoster #1712
Does the Teres Minor Muscle Status Affect the Active Rotation Movement in Reverse Total Shoulder Arthroplasty?
Laura Mariani, MD, Reading, Berkshire UNITED KINGDOM
Paolo Consigliere, MD, Reading, Berkshire UNITED KINGDOM
Luigi Piscitelli, MD, Crotone ITALY
Caroline Witney-Lagen, MD, Reading, Berkshire UNITED KINGDOM
Luis Natera, MD, Barcelona SPAIN
Andreas Leonidou, MD, Reading, Berkshire UNITED KINGDOM
Georgios Panagopoulos, MD, London UNITED KINGDOM
Giuseppe Sforza, Pratica Di Mare, Rome ITALY
Juan Bruguera, MD, Pamplona SPAIN
Ehud Atoun, MD, Karakur ISRAEL
Ofer Levy, MD, MCh(Orth), FRCS, Reading, Berkshire UNITED KINGDOM
Reading Shoulder Unit, Reading, Berkshire, UNITED KINGDOM
The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use: Innovative Design Orthopaedics, Verso TSA
Summary
To assess the correlation between teres minor (TM) integrity and fatty infiltration and postoperative active external rotation (AER) in patients operated with reverse total shoulder arthroplasty (rTSA).
Abstract
Introduction
rTSA provide good active elevation, however, there are concerns regarding deficient or absent active external rotation. The Teres Minor degeneration and fatty infiltration has been implicated.
Aim
To assess the correlation between teres minor (TM) integrity and fatty infiltration and postoperative active external rotation (AER) in patients operated with reverse total shoulder arthroplasty (rTSA).
Methods
Between 2005 and 2015, 109 shoulders in 97 patients (mean age 75.7±8.9; 31 M, 66 F) underwent a primary short metaphyseal rTSA for painful cuff tear arthropathy or massive irreparable rotator cuff tear with glenohumeral joint degeneration. Patients were prospectively clinically assessed preoperatively, at 3weeks, 3, 6, 12 months and yearly postoperatively: Constant Score (CS), Subjective Shoulder Value (SSV), Patient Satisfaction Score (PSS) were used. TM fatty infiltration was evaluated according to Goutallier classification, while TM muscular degeneration according to Walch morphological classification. Consequently, all the shoulders were divided in 2 groups respectively: group A, Goutallier grade 0-1-2; group B, Goutallier grade 3-4 and group A1, Walch hypertrophic/normal and group B1, Walch atrophic/absent.
Results
Group A included 68 shoulders, group A1 included 36 shoulders, group B included 41 shoulders and group B1 comprised 73 shoulders. The CS, SSV and AER improved significantly at 12-month follow-up assessment in all the patients (p <0.001). However, CS, AER and SSV have not showen statistically significant differences when comparing the different subgroups (A/B and A1/B1). Mean AER improved from 22.4?±21.6? preoperatively to 40.6?±17.5? postoperatively (+18.1?±21.5?) in all the subgroups.
Conclusion
TM degeneration does not seem to affect AER in patients that underwent rTSA for cuff tear arthropathy with the specific design of rTSA implant. It may, however, relate to specific design concepts of the implant used. Additional clinical and biomechanical studies are necessary to understand the reasons that have led to these results.