Anatomic total shoulder for patients over 75 with arthritis and partial-thickness cuff tears.

Preoperative partial-thickness rotator cuff tears do not compromise anatomic total shoulder replacement outcomes: medium-term follow-up

These authors reported the 5.8 year (range, 5-9 years) outcomes for 36 patients of 79.2 years (range, 75-88 years) with  partial-thickness rotator cuff tears on magnetic resonance imaging (MRI) scans.

Significant improvements in pain and range of movement were reported in all cases. While radiolucencies were seen around 8 glenoids, there were no cases of implant loosening. 

Four patients were noted to have rotator cuff weakness but only 2 showed evidence of proximal migration. One patient remained satisfied, whereas the other patient, with moderate-grade proximal migration, underwent revision for rotator cuff failure; one further patient underwent revision surgery for infection.

Comment: It would seem that partial thickness cuff lesions would be very common among individuals at 75 years of age or older. 

While some surgeons prefer reverse total shoulder for patients in this age group, our practice is to consider anatomic shoulder arthroplasty for such patients as long as they have good bone stock, good strength, no x-ray evidence of proximal migration and no pseudoparalysis.

 

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Here are some videos that are of shoulder interest

Shoulder arthritis - what you need to know (see this link).

How to x-ray the shoulder (see this link).

The ream and run procedure (see this link).

The total shoulder arthroplasty (see this link).

The cuff tear arthropathy arthroplasty (see this link).

The reverse total shoulder arthroplasty (see this link).

The smooth and move procedure for irreparable rotator cuff tears (see this link).

Shoulder rehabilitation exercises (see this link).