Low-term results from non-conventional partial arthroplasty for treating rotator cuff arthroplasthy

Tenor Júnior, Antônio Carlos; Lima, José Alano Benevides de; Vasconcelos, Iúri Tomaz de; Costa, Miguel Pereira da; Brasil Filho, Rômulo; Ribeiro, Fabiano Rebouças

doi:10.1016/j.rboe.2015.04.006

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Sumário

Original Articles • Rev. bras. ortop. 50 (3) • May-Jun 2015 • https://doi.org/10.1016/j.rboe.2015.04.006 copy

Low-term results from non-conventional partial arthroplasty for treating rotator cuff arthroplasthy^☆ ☆ Work developed in the Shoulder and Elbow Group, State Public Servants' Hospital, São Paulo, SP, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To evaluate the evolution of the functional results from CTA^(r)hemiarthroplasty for surgically treating degenerative arthroplathy of the rotator cuff, with a mean follow-up of 5.4 years.

METHODS:

Eighteen patients who underwent CTA^(r) partial arthroplasty to treat degenerative arthroplathy of the rotator cuff between April 2007 and June 2009 were reevaluated, with minimum and mean follow-ups of 4.6 years and 5.4 years, respectively. Pre and postoperative parameters for functionality and patient satisfaction were used (functional scale of the University of California in Los Angeles, UCLA). All the patients underwent prior conservative treatment for 6 months and underwent surgical treatment because of the absence of satisfactory results. Patients were excluded if they presented any of the following: previous shoulder surgery; pseudoparalysis; insufficiency of the coracoacromial arch (type 2 B in Seebauer's classification); neurological lesions; or insufficiency of the deltoid muscle and the subscapularis muscle.

RESULTS:

With a mean follow-up of 5.4 years, 14 patients considered that they were satisfied with the surgery (78%); the mean range of joint motion for active elevation improved from 55.8° before the operation to 82.0° after the operation; the mean external rotation improved from 18.9° before the operation to 27.3° after the operation; and the mean medial rotation remained at the level of the third lumbar vertebra. The mean UCLA score after the mean follow-up of 5.4 years was 23.94 and this was an improvement in comparison with the preoperative mean and the mean 1 year after the operation.

CONCLUSION:

The functional results from CTA^(r) hemiarthroplasty for treating rotator cuff arthroplasty in selected patients remained satisfactory after a mean follow-up of 5.4 years.

Replacement arthroplasty; Shoulder; Rotator cuff

Patient	Sex	Time since op (years)	Age	Side	UCLA before op	UCLA one year after op	UCLA final evaluation	Elev/ext rot/med rot before op	Elev/ext rot/med rot after op
1	M	6.7	86	D	1 + 2 + 1 + 3 + 0 = 7	10 + 4 + 1 + 3 + 0 = 18	10 + 4 + 2 + 2 + 0 = 18	30/10/L2	40/10/L2
2	M	6.6	69	D	2 + 2 + 2 + 3 + 0 = 9	8 + 4 + 3 + 3 + 5 = 23	10 + 10 + 5 + 4 + 5 = 34	80/40/L3	120/50/L2
3	M	6.5	79	ND	2 + 4 + 3 + 3 + 0 = 12	8 + 6 + 3 + 3 + 5 = 25	8 + 8 + 4 + 3 + 5 = 28	54/0/T11	130/10/T8
4	F	6.0	89	D	2 + 4 + 3 + 2 + 0 = 11	8 + 6 + 3 + 3 + 5 = 22	8 + 6 + 3 + 3 + 5 = 25	40/10/L1	56/10/L1
5	F	5.8	67	ND	2 + 2 + 1 + 3 + 0 = 8	10 + 6 + 2 + 3 + 5 = 26	10 + 8 + 2 + 2 + 5 = 27	50/20/T12	70/40/T11
6	F	5.7	88	D	2 + 2 + 0 + 3 + 0 = 7	8 + 6 + 2 + 4 + 0 = 20	8 + 6 + 3 + 3 + 0 = 20	68/24/T12	80/30/T12
7	F	5.5	77	D	2 + 4 + 1 + 2 + 0 = 9	8 + 4 + 1 + 3 + 5 = 21	10 + 4 + 0 + 2 + 5 = 21	12/10/L5	20/20/L3
8	F	5.4	81	D	2 + 2 + 2 + 3 + 0 = 9	8 + 8 + 3 + 4 + 5 = 28	8 + 6 + 3 + 3 + 5 = 25	60/40/L1	110/44/L1
9	F	5.2	73	D	2 + 2 + 1 + 3 + 0 = 8	4 + 4 + 3 + 3 + 0 = 14	2 + 4 + 3 + 3 + 0 = 12	62/10/L1	90/20/L2
10	F	5.1	84	D	2 + 2 + 2 + 2 + 0 = 8	4 + 6 + 3 + 2 + 0 = 25	6 + 4 + 3 + 4 + 0 = 17	60/20/T11	70/20/T10
11	F	5.0	78	D	2 + 4 + 3 + 2 + 0 = 11	6 + 8 + 5 + 4 + 5 = 28	6 + 8 + 5 + 4 + 5 = 28	70/20/L2	120/36/L2
12	F	4.9	72	ND	2 + 2 + 0 + 2 + 0 = 6	8 + 4 + 2 + 3 + 5 = 22	8 + 8 + 3 + 4 + 5 = 28	56/40/L3	70/44/L2
13	F	4.7	70	ND	2 + 4 + 3 + 2 + 0 = 11	8 + 6 + 2 + 3 + 5 = 24	8 + 6 + 2 + 3 + 5 = 24	50/16/L1	60/30/T12
14	F	4.6	74	D	2 + 2 + 2 + 3 + 0 = 9	4 + 4 + 3 + 4 + 5 = 20	8 + 8 + 5 + 4 + 5 = 30	60/10/T10	110/20/T8
15	F	4.6	83	D	2 + 2 + 1 + 3 + 0 = 8	6 + 4 + 2 + 3 + 5 = 18	6 + 4 + 3 + 3 +5 =21	52/10/Trochanter	70/26/Sacrum
16	F	4.6	81	D	2 + 4 + 3 + 2 + 0 = 11	8 + 8 + 4 + 4 + 5 = 29	8 + 6 + 4 + 4 + 5 = 27	70/10/T10	120/22/T8
17	F	5.2	87	D	1 + 2 + 3 + 3 + 0 = 9	6 + 4 + 3 + 3 + 5 = 21	6 + 4 + 3 + 3 + 5 = 21	40/20/L3	60/30/L3
18	F	6.0	66	ND	2 + 2 + 2 + 3 + 0 = 9	8 + 4 + 3 + 4 + 5 = 24	8 + 6 + 2 + 4 + 5 = 25	90/30/L5	80/30/L5

Variables	Before operation		One year afterwards		Final evaluation		p
	Mean (SP)	Min–Max	Mean (SP)	Min–Max	Mean (SP)	Min–Max
Pain	1.89 (0.32)	1–2	7.22 (1.83)	4–10	7.67 (1.97)	2–10	<0.001
Function	2.67 (0.97)	2–4	5.33 (1.53)	4–8	6.11 (1.88)	4–10	<0.001
Active flexion	1.83 (1.04)	0–3	2.67 (0.97)	1–5	3.06 (1.26)	0–5	<0.001
Flexion force	2.61 (0.50)	2–3	3.28 (0.57)	2–4	3.22 (0.73)	2–4	0003
Satisfaction	0.00 (0.00)	0–0	3.89 (2.14)	0–5	3.89 (2.14)	0–5	<0.001
UCLA score	9.00 (1.64)	6–12	22.39 (4.23)	14–29	23.94 (5.30)	12–34	<0.001

	Pain	Function	Active flexion	Flexion force	Satisfaction	UCLA score
Before operation vs. one year after operation	p < 0.001	p < 0.001	p < 0.002	p < 0.002	p < 0.001	p < 0.001
Before operation vs. final evaluation	p < 0.001	p < 0.001	p < 0.003	p < 0.005	p < 0.001	p < 0.001
One years after operation vs. final evaluation	p = 0.157	p = 0.448	p = 0.207	p = 1.00	p = 1.00	p = 0.303

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: actenorjr@hotmail.com (A.C. Tenor Júnior).

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Low-term results from non-conventional partial arthroplasty for treating rotator cuff arthroplasthy ☆ ☆ Work developed in the Shoulder and Elbow Group, State Public Servants' Hospital, São Paulo, SP, Brazil

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Low-term results from non-conventional partial arthroplasty for treating rotator cuff arthroplasthy^☆ ☆ Work developed in the Shoulder and Elbow Group, State Public Servants' Hospital, São Paulo, SP, Brazil