• Betsy M Nolan, Elizabeth Ankerson, and J Michael Wiater.
• Indiana University School of Medicine, Indiana University, 541 Clinical Drive, Suite 600, Indianapolis, IN 46202, USA. shoulderandelbowdoc@gmail.com
• Clin. Orthop. Relat. Res. 2011 Sep 1;469(9):2476-82.

BackgroundEarly failure due to glenoid loosening with anatomic total shoulder arthroplasty in patients with severe rotator cuff deficiency led to the development of the reverse ball-and-socket shoulder prosthesis. The literature reports improved short-term pain and function scores following modern reverse total shoulder arthroplasty (RTSA) in patients with cuff tear arthropathy (CTA).Questions/PurposesWe therefore sought to confirm previously reported short-term improvements in pain, function scores, and range of motion, in patients treated with RTSA for CTA and to identify clinical complications and radiographic notching.MethodsWe retrospectively reviewed 67 patients who underwent 71 primary RTSAs for CTA. The average age was 74 years (range, 54-92 years). All were preoperatively and postoperatively assessed using Constant-Murley and American Shoulder and Elbow Society (ASES) scores. We identified complications and examined radiographs for notching. The minimum followup was 12 months (average, 24 months; range, 12-58 months).ResultsAverage Constant-Murley scores improved from 28 preoperatively to 62 postoperatively. Average ASES scores improved from 26 to 76. Subjective Shoulder Value (SSV) improved from 23 to 77. Active forward flexion improved from 61° preoperatively (range, 0°-137°) to 121° postoperatively (range, 52°-170°). Active external rotation was not affected. Thirty-five of the 71 shoulders (49%) showed radiographic notching. The overall complication rate was 23%. No patient required reoperation. One patient required closed reduction of a perioperative dislocation.ConclusionsRTSA for CTA results in functional improvement, with a low complication rate. However, the longevity of the device is currently unknown.Level Of EvidenceLevel IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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