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Archives of Orthopaedic and Trauma Surgery

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Open Access 28-01-2021 | Painful Arc | Orthopaedic Surgery

Reverse total shoulder arthroplasty in massive rotator cuff tears: does the Hamada classification predict clinical outcomes?

Authors: Max J. Kääb, Georges Kohut, Ulrich Irlenbusch, Thierry Joudet, Falk Reuther

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2022

Abstract

Introduction

Reverse total shoulder arthroplasty (RTSA) is a widely recognized treatment to reduce pain and improve shoulder function for patients in various disease stages of cuff tear arthropathy (CTA). However, it remains unclear whether outcomes after RTSA depend on the preoperative stage of CTA. Therefore, this study evaluated whether the Hamada classification influences midterm clinical outcomes after RTSA.

Materials and methods

In this multicenter observational study, patients underwent inverted bearing RTSA for massive rotator cuff tears or CTA. Shoulders were grouped into those with (Hamada grades 4a, 4b, and 5) and those without (Hamada grades 1, 2, and 3) glenohumeral arthritis. Clinical outcomes, including range of motion, Constant score, American Shoulder and Elbow Surgeons score, and visual analog scale for pain and satisfaction, were determined preoperatively and at 24 and > 30 months. All complications were recorded, and survival free from any implant component revision was calculated.

Results

Overall, 202 patients (211 shoulders) were treated with RTSA at a mean age of 75.8 ± 6.6 years (range 41.9–91.6 years). Of these, 144 patients (151 shoulders) were available for a mean follow-up of 79.9 ± 24.7 months (range 30.2–132.3 months). No significant between-group differences were found for clinical outcomes at 24 and > 30 months (P > 0.05). Furthermore, the Hamada classification did not correlate with clinical outcomes at 24 (P = 0.98) and > 30 months (P = 0.29). Revision-free implant component survival was similar between groups (P = 0.17). Postoperative complications were found in 11 shoulders, of which 10 required revision.

Conclusions

Inverted bearing RTSA was found to be an effective treatment with similarly good midterm clinical outcomes, similar revision rates, and high implant survival rates in every stage of massive rotator cuff tears. Overall, the preoperative Hamada classification did not influence clinical outcomes or complications after RTSA.

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Title: Reverse total shoulder arthroplasty in massive rotator cuff tears: does the Hamada classification predict clinical outcomes?
Authors: Max J. Kääb
Georges Kohut
Ulrich Irlenbusch
Thierry Joudet
Falk Reuther
Publication date: 28-01-2021
Publisher: Springer Berlin Heidelberg
Keyword: Painful Arc
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 7/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-03755-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reverse total shoulder arthroplasty in massive rotator cuff tears: does the Hamada classification predict clinical outcomes?

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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