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Subscapularis-sparing deltopectoral approach in reverse total shoulder arthroplasty

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Abstract

Purpose

This study compared the clinical and radiologic results of reverse shoulder arthroplasty (RSA) using either the subscapularis-sparing deltopectoral approach (SSDA) or traditional deltopectoral approach (TDA) in cuff tear arthropathy patients.

Materials and method

We retrospectively evaluated 71 patients who underwent RSA for cuff tear arthropathy between July 2014 and December 2018. Patients were divided into two groups according to the surgical approach: TDA (34 cases) and SSDA (37 cases). The mean patient age was 78.6 years, and the mean (range) follow-up period was 23.5 (12–48) months. Clinical results were assessed using the Visual Analogue pain Scale (VAS), American Shoulder and Elbow Surgeon score (ASES), Korean Shoulder Scoring System (KSS), and Constant score. Radiographic indicators prosthesis-scapular neck angle (PSNA), peg-glenoid rim distance (PGRD), inferior overhang, acromion-greater tuberosity (AT) distance, and glenoid-greater tuberosity (GT) distance) were assessed, and notching severity was assessed according to the Nerot-Sirveaux classification.

Results

The radiographic indicator results of the TDA and SSDA groups were as follows: PSNA (131.4° ± 17.2°, 136.1° ± 7.7°), PGRD (18.7 mm ± 2.9 mm, 21.4 mm ± 2.0 mm), AT distance (38.3 mm ±6.9 mm, 37.5 mm ± 6.8 mm), GT distance (51.6 mm ± 6.3 mm, 51.4 mm ± 5.3 mm), and inferior overhang (4.4 mm ± 2.2 mm, 2.9 mm ± 1.3 mm). PGRD and inferior overhang showed statistically significant differences between groups, but the clinical results showed no significant differences. There were no complications such as neurovascular injury, implant loosening, surgical site infection, or acromion fracture in either group.

Conclusion

SSDA for RSA showed no significant differences in clinical and radiological results compared with TDA. Therefore, SSDA is a viable alternative for RSA in cuff tear arthropathy.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, South Korea

    Ki-Yong An & Ji-Yeon Park

  2. Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, South Korea

    Taek-Rim Yoon

Authors
  1. Ki-Yong An
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  2. Ji-Yeon Park
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  3. Taek-Rim Yoon
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Contributions

All the authors contributed to the study conception and design. All the authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Taek-Rim Yoon.

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Ethics approval

The study protocol was approved by Institutional Review Board of Gwangju Veterans Hospital (IRB No. 2022-00-000-000).

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The requirement for informed consent was waived because of the study’s retrospective design.

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Not applicable.

Competing interests

The authors declare no competing interests.

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An, KY., Park, JY. & Yoon, TR. Subscapularis-sparing deltopectoral approach in reverse total shoulder arthroplasty. International Orthopaedics (SICOT) 46, 2845–2851 (2022). https://doi.org/10.1007/s00264-022-05591-y

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  • DOI: https://doi.org/10.1007/s00264-022-05591-y

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