Thirty-six consecutive reverse shoulder arthroplasties in cuff arthropathy: Our experience with the anterosuperior approach

摘要

Background: The purpose of this study was to analyze the results obtained with the anterosuperior approach with reverse shoulder arthroplasty in terms of functional recovery, pain, and stability of the implant. Methods: In a cohort of 33 patients with cuff arthropathy, 36 consecutive reverse shoulder arthroplasties were implanted by the same surgeon, using the anterosuperior approach, saving the subscapularis tendon. Those cases were evaluated preoperatively and postoperatively after an average of 37 months on the basis of constant score, X-ray evaluation, and incidence of dislocation. Results: The constant score increased from 30.4 points preoperatively to 68.3 points. No case of instability was observed. Conclusions: The good functional results observed with a mean follow-up of approximately 3 years doubtlessly resulted from the correct surgical technique on the glenoid component and the preservation of the anterior wall composed of the subscapularis tendon. Analyzing literature and taking into account our experience, we can say that the anterosuperior approach has certain advantages; this approach takes advantage of the absence of the upper part of the rotator cuff to facilitate exposure of the joint that makes it particularly indicated in cuff arthropathy.