Rotator Cuff Dysfunction after Anatomic Total Shoulder Arthroplasty: Who is at Risk?

We compare posttotal shoulder arthroplasty (TSA) patients with suspected cuff dysfunction to a successfulTSA control group. Thirtynine patients met suspectedcuffdysfunction criteria. Forty matched controls were selected. Radiographic and functional outcomes and demographics were compared preoperatively and postoperatively. Humeral head height above the greater tuberosity and postoperative humeral head translations were significantly greater in the dysfunction group. The dysfunction group demonstrated a significant correlation between higher humeral heads and earlier postoperative dysfunction, significantly more glenoid radiolucencies, and significant deficits in active and passive forward elevation. External rotation did not differ significantly until the final follow up. Functional scores differed significantly by 6 months, with the exception of the 1year American Shoulder and Elbow Surgeons score. PostTSA cuff dysfunction leads to worse functional scores, worse range of motion, and more glenoid radiolucencies. Proper patient selection and humeral head placement may prevent this. Early postoperative forwardelevation stiffness may portend dysfunction. (Journal of Surgical Orthopaedic Advances 29(1):3135, 2020).