Clin Orthop Surg.  2017 Jun;9(2):213-217. 10.4055/cios.2017.9.2.213.

Clinical Outcomes and Complications during the Learning Curve for Reverse Total Shoulder Arthroplasty: An Analysis of the First 40 Cases

• Cho CH
• Song KS
• Koo TW

• KMID: 2412291
• DOI: http://doi.org/10.4055/cios.2017.9.2.213

Abstract

BACKGROUND
The purpose of this study was to investigate the results and complications during the learning curve of reverse total shoulder arthroplasty (RTSA) for rotator cuff deficiency.
METHODS
We retrospectively reviewed the first 40 cases of RTSA performed by a single surgeon. The mean age of patients was 72.7 years (range, 63 to 81 years) and mean follow-up period was 26.7 months (range, 9 to 57 months). Clinical outcomes were evaluated using a visual analog scale (VAS) for pain, the University of California at Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeon (ASES) score, subjective shoulder value (SSV), and active range of motion (ROM). Intraoperative and postoperative complications were also evaluated.
RESULTS
The average VAS pain score, UCLA score, ASES score, and SSV improved from 6.9%, 12.8%, 29.0%, and 29.0% before surgery to 1.6%, 27.0%, 73.3%, and 71.5% after surgery, respectively (p < 0.001). The mean forward flexion, abduction, and external rotation improved from 68.0°, 56.9°, and 28.0° before surgery to 131.0°, 112.3°, and 38.8° after surgery, respectively (p < 0.001, p < 0.001, and p = 0.021). However, the mean internal rotation did not improve after surgery (p = 0.889). Scapular notching was observed in 33 patients (51.5%). Eight shoulders (20%) had complications, including 2 major (1 deep infection and 1 glenoid fixation failure) and 6 minor complications (3 brachial plexus injuries, 2 acromial fractures, and 1 intraoperative periprosthetic fracture).
CONCLUSIONS
The first 40 cases of RTSA performed by a single surgeon during the learning curve period showed satisfactory short-term follow-up results with an acceptable complication rate.

Keyword

Shoulder; Arthroplasty; Reverse; Outcome; Complication

MeSH Terms

Aged
Aged, 80 and over
*Arthroplasty, Replacement, Shoulder/adverse effects/methods/statistics & numerical data
Female
Humans
Learning Curve
Male
Middle Aged
Postoperative Complications/*epidemiology
Retrospective Studies
Treatment Outcome

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