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Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review

Rotator cuff tears have been reported to be uncommon following total shoulder arthroplasty (TSA). Postoperative rotator cuff tears can lead to pain, proximal humeral migration, and glenoid component loosening. The purpose of this paper was to evaluate the incidence of post-TSA rotator cuff tears or...

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Autores principales: Levy, David M., Abrams, Geoffrey D., Harris, Joshua D., Bach, Bernard R., Nicholson, Gregory P., Romeo, Anthony A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857535/
https://www.ncbi.nlm.nih.gov/pubmed/27186060
http://dx.doi.org/10.4103/0973-6042.180720
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author Levy, David M.
Abrams, Geoffrey D.
Harris, Joshua D.
Bach, Bernard R.
Nicholson, Gregory P.
Romeo, Anthony A.
author_facet Levy, David M.
Abrams, Geoffrey D.
Harris, Joshua D.
Bach, Bernard R.
Nicholson, Gregory P.
Romeo, Anthony A.
author_sort Levy, David M.
collection PubMed
description Rotator cuff tears have been reported to be uncommon following total shoulder arthroplasty (TSA). Postoperative rotator cuff tears can lead to pain, proximal humeral migration, and glenoid component loosening. The purpose of this paper was to evaluate the incidence of post-TSA rotator cuff tears or dysfunction in osteoarthritic patients. A systematic review of multiple databases was performed using preferred reporting items for systematic reviews and meta-analyses guidelines. Levels I-IV evidence clinical studies of patients with primary osteoarthritis with a minimum 2-year follow-up were included. Fifteen studies with 1259 patients (1338 shoulders) were selected. Student's t-tests were used with a significant alpha value of 0.05. All patients demonstrated significant improvements in motion and validated clinical outcome scores (P < 0.001). Radiographic humeral head migration was the most commonly reported data point for extrapolation of rotator cuff integrity. After 6.6 ± 3.1 years, 29.9 ± 20.7% of shoulders demonstrated superior humeral head migration and 17.9 ± 14.3% migrated a distance more than 25% of the head. This was associated with an 11.3 ± 7.9% incidence of postoperative superior cuff tears. The incidence of radiographic anterior humeral head migration was 11.9 ± 15.9%, corresponding to a 3.0 ± 13.6% rate of subscapularis tears. We found an overall 1.2 ± 4.5% rate of reoperation for cuff injury. Nearly all studies reported indirect markers of rotator cuff dysfunction, such as radiographic humeral head migration and clinical exam findings. This systematic review suggests that rotator cuff dysfunction following TSA may be more common than previously reported. IV, systematic review of Levels I-IV studies.
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spelling pubmed-48575352016-05-16 Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review Levy, David M. Abrams, Geoffrey D. Harris, Joshua D. Bach, Bernard R. Nicholson, Gregory P. Romeo, Anthony A. Int J Shoulder Surg Review Article Rotator cuff tears have been reported to be uncommon following total shoulder arthroplasty (TSA). Postoperative rotator cuff tears can lead to pain, proximal humeral migration, and glenoid component loosening. The purpose of this paper was to evaluate the incidence of post-TSA rotator cuff tears or dysfunction in osteoarthritic patients. A systematic review of multiple databases was performed using preferred reporting items for systematic reviews and meta-analyses guidelines. Levels I-IV evidence clinical studies of patients with primary osteoarthritis with a minimum 2-year follow-up were included. Fifteen studies with 1259 patients (1338 shoulders) were selected. Student's t-tests were used with a significant alpha value of 0.05. All patients demonstrated significant improvements in motion and validated clinical outcome scores (P < 0.001). Radiographic humeral head migration was the most commonly reported data point for extrapolation of rotator cuff integrity. After 6.6 ± 3.1 years, 29.9 ± 20.7% of shoulders demonstrated superior humeral head migration and 17.9 ± 14.3% migrated a distance more than 25% of the head. This was associated with an 11.3 ± 7.9% incidence of postoperative superior cuff tears. The incidence of radiographic anterior humeral head migration was 11.9 ± 15.9%, corresponding to a 3.0 ± 13.6% rate of subscapularis tears. We found an overall 1.2 ± 4.5% rate of reoperation for cuff injury. Nearly all studies reported indirect markers of rotator cuff dysfunction, such as radiographic humeral head migration and clinical exam findings. This systematic review suggests that rotator cuff dysfunction following TSA may be more common than previously reported. IV, systematic review of Levels I-IV studies. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4857535/ /pubmed/27186060 http://dx.doi.org/10.4103/0973-6042.180720 Text en Copyright: © 2016 International Journal of Shoulder Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Review Article
Levy, David M.
Abrams, Geoffrey D.
Harris, Joshua D.
Bach, Bernard R.
Nicholson, Gregory P.
Romeo, Anthony A.
Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review
title Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review
title_full Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review
title_fullStr Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review
title_full_unstemmed Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review
title_short Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review
title_sort rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857535/
https://www.ncbi.nlm.nih.gov/pubmed/27186060
http://dx.doi.org/10.4103/0973-6042.180720
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