INVERTED SHOULDER PROSTHESES FOR ARTHROSIS SECONDARY TO MASSIVE RUPTURE OF THE ROTATOR CUFF

Abstract

Introduction and Objectives: Treatment of arthrosis secondary to massive rupture of the rotator cuff using anatomical prostheses has offered limited results. The growing use of inverted prostheses, with biomechanics completely different from anatomical prostheses, have given promising results and offer an alternative treatment for this problem as well as other functionally-similar pathologies.

Materials and Methods: This multicentre study included 25 patients with Delta III inverted prostheses (IP) from Puy®, with a minimum follow-up period ranging from 3 to 22 months. There were 23 females and 2 males in the study. Average age was 71.04 years. Pre-operative diagnoses included arthrosis secondary to massive rupture of the rotator cuff (15), prosthesis revision (4), fracture sequelae (3) and acute fracture (3). Average preoperative Constant score with secondary arthrosis was 21.

Results: Evaluation using the Constant scoring system yielded the following mean results: secondary arthrosis of less than 6 months progression: 55.75; greater than 6 months progression: 58.14; prosthetic replacement at less than 6 months of progression: 32; and fracture sequelae of more than 6 months progression: 47.66. There was one postoperative dislocation, which required corrective surgery, and one infection that required surgical cleaning.

Discussion and Conclusions: 1). Good results were achieved using inverted prostheses in the treatment of arthrosis secondary to massive rupture of the rotator cuff (average 37 point improvement in Constant score.) 2). Limited results were attained for other conditions. The most significant result was reduction in pain.