Functional Outcomes and Complications Following Greater Tuberosity Resurfacing for Compensated Cuff Arthropathy

Patients with large, irreparable rotator cuff tears may develop a compensated cuff arthropathy (CCA) with persistent shoulder pain from contact between the humeral head and acromion. This study reports shoulder pain relief, functional outcomes, and complications in CCA patients treated with greater tuberosity resurfacing (GTR).

A retrospective case-series review of patients who underwent GTR between 2014 and 2021 by a single community hospital-based surgeon was conducted. Patients who failed nonoperative treatment underwent diagnostic arthroscopy. If the rotator cuff was deemed irreparable intraoperatively, a metallic implant (HemiCAP) was placed at the supraspinatus insertion via a miniopen deltoid splitting approach. Postoperatively, patients followed a standard physiotherapy regimen. Shoulder range of motion, American Shoulder and Elbow Surgeons (ASES) assessment form, Pennsylvania Shoulder Score (PSS), satisfaction scores were collected, and complications recorded.

Of the 33 shoulders, (32 patients), that had a GTR, 29 shoulders (28 patients) were included in the final analysis (two patients were converted to reverse shoulder arthroplasty, one was lost to follow-up, and one was deceased). Mean age was 69 years. Mean follow-up was 48 months. Mean postoperative ASES and PSS were 79 and 74, respectively. Patients were very satisfied with the procedure in 18 (62%) shoulders and satisfied in five (17%) shoulders. Twenty-four patients (86%) with 25 shoulders (86%) stated they would recommend the procedure.

GTR for CCA showed significant pain relief, acceptable functional outcomes, and low revision rates. GTR reduces pain and maintains function in patients with CCA and minimal glenohumeral arthritis. Level of Evidence: IV.