Clinical Outcomes After Reverse Shoulder Arthroplasty With and Without Subscapularis Repair: The Importance of Considering Glenosphere Lateralization

Publication Date

2018

Journal Title

J Am Acad Orthop Surg

Abstract

INTRODUCTION: Recent biomechanical data suggests that repairing the subscapularis during reverse shoulder arthroplasty (RSA) can increase the force required by the posterior rotator cuff and deltoid to elevate the arm.METHODS: We retrospectively studied patients who underwent primary RSA and had baseline and minimum 2-year postoperative American Shoulder and Elbow Surgeons (ASES) shoulder scores, stratified them according to subscapularis management, then subgrouped them according to lateralization of the glenosphere component.RESULTS: Patients with subscapularis repair and a lateralized glenosphere had significantly less improvement in ASES scores than did those without lateralization (P = 0.016) and patients without subscapularis repair (P = 0.006). Individually, subscapularis management (P = 0.163) and glenosphere lateralization (P = 0.847) had no significant effect on the change in ASES score but in combination did have a significant effect on the change in ASES score (P = 0.002).DISCUSSION: The combination of subscapularis repair and glenosphere implant lateralization in RSA translates to significantly less clinical improvement.CONCLUSIONS: Patients who underwent both subscapularis repair and glenosphere lateralization had significantly less improvement in ASES scores.LEVEL OF EVIDENCE: Level III.

Volume Number

26

Issue Number

5

Pages

e114 - e119

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Orthopedic Surgery

PMID

29419724

DOI

10.5435/JAAOS-D-16-00781

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