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Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair

BACKGROUND: In performing reverse total shoulder arthroplasty (rTSA), the role of repairing the subscapularis has been debated. Our objective was to determine the effect of subscapularis repair following rTSA on postoperative shoulder ranges of motion and patient reported outcome scores (PROs). METH...

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Autores principales: Oak, Sameer R., Kobayashi, Evangeline, Gagnier, Joel, Denard, Patrick J., Sears, Benjamin W., Gobezie, Reuben, Lederman, Evan, Werner, Brian C., Bedi, Asheesh, Miller, Bruce S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637760/
https://www.ncbi.nlm.nih.gov/pubmed/36353412
http://dx.doi.org/10.1016/j.jseint.2022.07.009
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author Oak, Sameer R.
Kobayashi, Evangeline
Gagnier, Joel
Denard, Patrick J.
Sears, Benjamin W.
Gobezie, Reuben
Lederman, Evan
Werner, Brian C.
Bedi, Asheesh
Miller, Bruce S.
author_facet Oak, Sameer R.
Kobayashi, Evangeline
Gagnier, Joel
Denard, Patrick J.
Sears, Benjamin W.
Gobezie, Reuben
Lederman, Evan
Werner, Brian C.
Bedi, Asheesh
Miller, Bruce S.
author_sort Oak, Sameer R.
collection PubMed
description BACKGROUND: In performing reverse total shoulder arthroplasty (rTSA), the role of repairing the subscapularis has been debated. Our objective was to determine the effect of subscapularis repair following rTSA on postoperative shoulder ranges of motion and patient reported outcome scores (PROs). METHODS: A prospective registry was reviewed to establish a cohort of primary rTSA patients with a 135-degree humeral implant, with a minimum of 2 years of follow-up. Variables collected included demographics, subscapularis repair information, diagnosis, glenosphere size, and glenoid lateralization information. Outcomes collected were range of motion measurements, subscapularis strength, and multiple generic and shoulder PROs. Multivariable linear regression models were created to predict these 2-year outcomes. RESULTS: The 143-patient cohort had a mean age of 69 years with 68% of patients undergoing subscapularis repair. After adjustment in the multivariable models, whether the subscapularis was repaired did not significantly predict a 2-year forward elevation, external rotation, internal rotation, subscapularis strength, Western Ontario Osteoarthritis of the Shoulder score, VR-12 scores, Constant Score, or American Shoulder and Elbow Surgeons Shoulder Scores. Increased glenoid lateralization significantly predicted greater internal rotation, higher VR-12 physical score, and higher Constant Score. There were no dislocations in either group. CONCLUSIONS: After adjusting for patient and implant factors, subscapularis repair was not associated with a 2-year postoperative range of motion, strength, or any PROs suggesting that repairing the subscapularis may not affect functional outcome. Increased glenoid lateralization through the baseplate and glenosphere independently predicted better internal rotation, VR-12 physical score, and Constant Scores indicating a benefit to lateralization during rTSA.
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spelling pubmed-96377602022-11-08 Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair Oak, Sameer R. Kobayashi, Evangeline Gagnier, Joel Denard, Patrick J. Sears, Benjamin W. Gobezie, Reuben Lederman, Evan Werner, Brian C. Bedi, Asheesh Miller, Bruce S. JSES Int Shoulder BACKGROUND: In performing reverse total shoulder arthroplasty (rTSA), the role of repairing the subscapularis has been debated. Our objective was to determine the effect of subscapularis repair following rTSA on postoperative shoulder ranges of motion and patient reported outcome scores (PROs). METHODS: A prospective registry was reviewed to establish a cohort of primary rTSA patients with a 135-degree humeral implant, with a minimum of 2 years of follow-up. Variables collected included demographics, subscapularis repair information, diagnosis, glenosphere size, and glenoid lateralization information. Outcomes collected were range of motion measurements, subscapularis strength, and multiple generic and shoulder PROs. Multivariable linear regression models were created to predict these 2-year outcomes. RESULTS: The 143-patient cohort had a mean age of 69 years with 68% of patients undergoing subscapularis repair. After adjustment in the multivariable models, whether the subscapularis was repaired did not significantly predict a 2-year forward elevation, external rotation, internal rotation, subscapularis strength, Western Ontario Osteoarthritis of the Shoulder score, VR-12 scores, Constant Score, or American Shoulder and Elbow Surgeons Shoulder Scores. Increased glenoid lateralization significantly predicted greater internal rotation, higher VR-12 physical score, and higher Constant Score. There were no dislocations in either group. CONCLUSIONS: After adjusting for patient and implant factors, subscapularis repair was not associated with a 2-year postoperative range of motion, strength, or any PROs suggesting that repairing the subscapularis may not affect functional outcome. Increased glenoid lateralization through the baseplate and glenosphere independently predicted better internal rotation, VR-12 physical score, and Constant Scores indicating a benefit to lateralization during rTSA. Elsevier 2022-08-10 /pmc/articles/PMC9637760/ /pubmed/36353412 http://dx.doi.org/10.1016/j.jseint.2022.07.009 Text en © 2022 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Shoulder
Oak, Sameer R.
Kobayashi, Evangeline
Gagnier, Joel
Denard, Patrick J.
Sears, Benjamin W.
Gobezie, Reuben
Lederman, Evan
Werner, Brian C.
Bedi, Asheesh
Miller, Bruce S.
Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair
title Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair
title_full Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair
title_fullStr Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair
title_full_unstemmed Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair
title_short Patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair
title_sort patient reported outcomes and ranges of motion after reverse total shoulder arthroplasty with and without subscapularis repair
topic Shoulder
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637760/
https://www.ncbi.nlm.nih.gov/pubmed/36353412
http://dx.doi.org/10.1016/j.jseint.2022.07.009
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