These authors compared the outcomes of reverse total shoulder (RSA) for 24 patients with rheumatoid arthritis (RA) with those of 35 patients with cuff tear arthropathy (CTA) after and average follow-up period of 31 months (range, 24-64 months).
The Aequalis Reverse prosthesis (standard stem) was used in 27 cases and the Aequalis
Ascend Flex prosthesis (short stem) in 34 cases.
There was no statistically significant difference between the RA group and the CTA group in the clinical outcomes.
However glenoid component superior tilt was more likely in the RA group (12 of 24) than in the CTA group (4 of 35).
Complications occurred in 7 of 26 patients (27%) with RA and 3 of 35 patients (9%) with CTA.
Within the RA group, complications included greater tuberosity fractures in 4, lesser tuberosity in 1, glenoid fracture in 1, and transient musculocutaneous nerve palsy in 1.
Within the CTA group, complications included lesser tuberosity fracture in 1, acromial fracture in 1, and periprosthetic humeral fracture in 1.
Comment: The relatively high rate of fracture in both groups is noteworthy. The paper does not reveal whether these fractures occurred with the standard stem system
or the short stem system, which relies on a tight metaphyseal fit. A press fit in soft rheumatoid bone may carry the risk of fractureTo see a YouTube of our technique for a reverse total shoulder arthroplasty with humeral component fixation using impaction grafting, click on this link.
===
How you can support research in shoulder surgery Click on this link.
We have a new set of shoulder youtubes about the shoulder, check them out at this link.
Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link
Use the "Search" box to the right to find other topics of interest to you.