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01-11-2019 | Original Paper

The role of the subscapularis tendon in a lateralized reverse total shoulder arthroplasty: repair versus nonrepair

Authors: Edoardo Franceschetti, Edoardo Giovannetti de Sanctis, Riccardo Ranieri, Alessio Palumbo, Michele Paciotti, Francesco Franceschi

Published in: International Orthopaedics | Issue 11/2019

Abstract

Purpose

The reverse shoulder prost hesis (rTSA) is now implanted by the same percentage of anatomic shoulder prosthesis in the USA. Scapular notching and loss of extrarotation have been underlined as complication at long-term follow-up due to the Grammont design. The current trend to reduce those limits is to position both components lateralized. As the role of the subscapularis tendon in this new rTSA design is unclear, the purpose of this study is to quantify rTSA outcomes in patients with or without subscapularis tendon suture.

Methods

The surgery was performed by the same orthopaedic surgeon (F.F.), using a Aequalis Ascend™ Flex prosthesis (Tornier, Montbonnot, France) with a bone autograft.

Forty-four patients underwent surgery with the tendon sutured, whereas 40 patients underwent the same surgery without repairing it.

Patients were evaluated pre-operatively and at the last follow-up using Constant score, VAS, and ROM. The minimum and mean follow-ups were six and 16.6 months, respectively.

Results

All patients showed statistically significant improvement in pain and joint function following surgery. This study highlighted significant higher values in intrarotation and abduction, respectively, with and without suturing the subscapularis tendon.

However, no significant differences were underlined in Constant score, VAS, forward flexion, extrarotation at 0° and 90° of abduction, and rate of instability.

Conclusions

As predicted, significant clinical improvements were observed in both groups with some differences.

These clinical results showed that the use of rTSA with lateralized humerus and bony increase offset leads to realistic clinical improvements with a low risk of instability without the need for compression and stabilization of the tendon.

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Title: The role of the subscapularis tendon in a lateralized reverse total shoulder arthroplasty: repair versus nonrepair
Authors: Edoardo Franceschetti
Edoardo Giovannetti de Sanctis
Riccardo Ranieri
Alessio Palumbo
Michele Paciotti
Francesco Franceschi
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 11/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-4275-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The role of the subscapularis tendon in a lateralized reverse total shoulder arthroplasty: repair versus nonrepair

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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