Previous Rotator Cuff Repair Is Associated With Inferior Clinical Outcomes After Reverse Total Shoulder Arthroplasty

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2017 Oct 21

PMID 29051900

Citations 18

Authors

Edward J W Shields

Denise M Koueiter

Tristan Maerz

Adam Schwark

J Michael Wiater

Affiliations

Soon will be listed here.

Abstract

Background: Although recent evidence suggests that any prior shoulder surgery may cause inferior shoulder arthroplasty outcomes, there is no consensus on whether previous rotator cuff repair (RCR) is associated with inferior outcomes after reverse total shoulder arthroplasty (RTSA).

Purpose: To retrospectively compare outcomes in patients who underwent RTSA with and without previous RCR.

Study Design: Cohort study; Level of evidence, 3.

Methods: Patients with prior RCR and those without previous shoulder surgery (control) who underwent RTSA for cuff tear arthropathy or irreparable cuff tear were retrospectively identified from a prospective database. Exclusion criteria included revision arthroplasty, fractures, rheumatoid arthritis, dislocations, infection, prior non-RCR procedures, less than 12 months of follow-up, and latissimus dorsi tendon transfer. The American Shoulder and Elbow Surgeons (ASES) score, ASES Activities of Daily Living (ADL) score, visual analog scale (VAS) score for pain, Subjective Shoulder Value (SSV), and range of motion (ROM) were compared between groups.

Results: Patients with previous RCR (n = 83 shoulders) were younger (mean ± SD, 67 ± 10 vs 72 ± 8 years; < .001) and more likely to be male (46% vs 32%, = .033) than controls (n = 189 shoulders). No differences were found in follow-up duration (25 ± 13 vs 26 ± 13 months, = .734), body mass index, or any preoperative outcome variable or ROM measure. At final follow-up, patients with previous RCR had significantly lower ASES (76.5 [95% CI, 71.2-81.7] vs 85.0 [82.6-87.5], = .015), lower SSV (76 [72-81] vs 86 [83-88], < .001), worse pain (2.0 [1.4-2.6] vs 0.9 [0.6-1.1], < .001), and less improvement in the ASES, ASES ADL, VAS, SSV, and forward elevation measures than controls. Multivariable linear regression analysis demonstrated that previous RCR was significantly associated with lower postoperative ASES score ( = -9.5, < .001), lower ASES improvement ( = -7.9, = .012), worse postoperative pain ( = 0.9, = .001), worse improvement in pain ( = -1.0, = .011), lower postoperative SSV ( = -9.2, < .001), lower SSV improvement ( = -11.1, = .003), and lower forward elevation ROM improvement ( = -12.7, = .008).

Conclusion: Patients with previous RCR attempts may experience fewer short-term gains in functional and subjective outcome scores after RTSA compared with patients with no history of shoulder surgery who undergo RTSA. However, the differences between groups were small and below the minimal clinically important differences for the outcome measures analyzed.

Citing Articles

In Patients With Bilateral Rotator Cuff Tear, Staged Surgery is Superior to Simultaneous Surgery: A Systematic Review.

Davis G, Zareef U, Perez A, Paul R, Givner D, Erickson B Arthrosc Sports Med Rehabil. 2025; 7(1):101033.

PMID: 40041817 PMC: 11873471. DOI: 10.1016/j.asmr.2024.101033.

Prior nonarthroplasty shoulder surgery and modifiable risk factors negatively affect patient outcomes after shoulder arthroplasty.

Burns K, Robbins L, LeMarr A, Morton D, Gopinatth V, Wilson M JSES Int. 2025; 8(6):1234-1240.

PMID: 39822843 PMC: 11733542. DOI: 10.1016/j.jseint.2024.07.011.

Hesseling B, Prinsze N, Jamaludin F, Perry S, Eygendaal D, Mathijssen N Syst Rev. 2024; 13(1):286.

PMID: 39578927 PMC: 11583791. DOI: 10.1186/s13643-024-02694-y.

Glenoid notching after reverse shoulder arthroplasty: The influence of different neck-shaft angles.

Pereira C, Carrapatoso M, Barros L, Claro R Shoulder Elbow. 2024; :17585732241262524.

PMID: 39552695 PMC: 11562383. DOI: 10.1177/17585732241262524.

Is the impact of previous rotator cuff repair on the outcome of reverse shoulder arthroplasty clinically relevant? A systematic review of 2879 shoulders.

Berk A, Rao A, Obana K, Ifarraguerri A, Trofa D, Connor P Shoulder Elbow. 2024; :17585732241268712.

PMID: 39552683 PMC: 11562392. DOI: 10.1177/17585732241268712.

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