Reverse total shoulder replacement for patients with "weight-bearing" shoulders

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Reverse total shoulder arthroplasty (rTSA) is increasingly utilized for diverse shoulder pathologies.
• Weight-bearing shoulders, particularly in wheelchair or crutch users, present unique challenges and higher risks for rTSA.
• This study evaluates the outcomes of rTSA in patients with weight-bearing shoulder conditions.

Purpose of the Study:

• To assess the efficacy and safety of reverse total shoulder arthroplasty (rTSA) in patients with weight-bearing shoulders.
• To evaluate functional outcomes, pain reduction, and patient satisfaction after rTSA in this specific patient group.

Main Methods:

• A cohort of 24 patients (30 shoulders) with weight-bearing shoulders underwent rTSA between 2005 and 2014.
• Indications included cuff arthropathy, inflammatory arthritis, osteoarthritis, and fractures.
• Follow-up was conducted in 2016, with 21 patients (27 shoulders) available for a mean of 5.6 years.

Main Results:

• Significant improvements were observed in Constant-Murley scores (9.4 to 59.8) and pain scores (2/15 to 13.8/15).
• Patient satisfaction (Subjective Shoulder Value) increased from 0.6/10 to 8.7/10.
• Mean range of motion improved substantially, with notable gains in elevation, external rotation, and internal rotation.

Conclusions:

• Reverse total shoulder arthroplasty is a viable treatment option for patients with weight-bearing shoulders.
• Patients reported pain-free movement, successful resumption of daily activities, and high satisfaction rates post-surgery.
• Low rates of glenoid notching (grades 1 and 2) were observed.