Reverse Shoulder Arthroplasty in the Treatment of Cuff Tear Arthropathy: Systematic Review

Yıl 2024, , 215 - 221, 31.07.2024

Murat Aşcı

https://doi.org/10.16899/jcm.1504990

Öz

Purpose: In our study, we aimed to examine the results and complications of reverse shoulder prosthesis (RSA) applied after rotator cuff tear arthropathy (CTA) in the light of the current literature.
Methods: The literature search was conducted simultaneously on 1 April 2024 in the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases using the ''reverse total shoulder arthroplasty'', ''reverse total shoulder prosthesis'', ''cuff tear arthropathy'', ''outcomes'' and ''complications'' keywords. Only clinical review published in English in peer-reviewed journals was evaluated. The comparison between preoperative and postoperative clinical scores, as well as range of motion (ROM), was performed using the Wilcoxon–Mann–Whitney test. P values lower than 0.05 were considered statistically significant.
Results: 12 articles were included in our study. When comparing the results of the pre- and postoperative examinations, a statistically significant improvement in the range of motion and the functional score was found. It was found that various complications occurred in 21.1% of patients. The most common complication is scapular notching, which occurred in 13.8% of patients. Revision surgery was required in 1.57% of patients. The most common cause of revision was a periprosthetic joint infection.
Conclusion: In CTA patients, RSA can achieve both freedom from pain in the shoulder joint and an increase in function. Despite positive results, complications of varying degrees of severity can occur in around one fifth of patients. The lack of Level I studies limits a true understanding of the possibilities and limitations of RSA in the treatment of CTA patients.

Anahtar Kelimeler

Cuff tear arthropaty, Reverse total shoulder arthroplasty, Outcomes, Complications

Etik Beyan

Since it was a systematic review based on literature review, ethics committee approval was not required.

Teşekkür

I would like to thank Mete Gedikbaş, Ass. Prof. and Utkan Sobay M.D. for their efforts in researching the literature for this study.

Omuz Rotator Manşet Yırtığı Artropatisi Tedavisinde Ters Omuz Artroplastisi: Sistematik Derleme

Öz

Amaç: Çalışmamızda güncel literatür eşliğinde rotator manşet yırtığı artropatisi (CTA) sonrasında uygulanan ters omuz protezinin (RSA) sonuçlarını ve komplikasyonlarını incelemeyi amaçladık.
Gereç ve Yöntem: Yöntemler Literatür taraması 1 Nisan 2024 tarihinde Medline, Cochrane, EMBASE, Google Scholar ve Ovid veritabanlarında ''ters total omuz artroplastisi'', ''ters total omuz protezi'', ''manşet yırtığı artropatisi'', ''sonuçlar'' ve ''komplikasyonlar'' anahtar kelimeleri kullanılarak eş zamanlı olarak yapılmıştır. Yalnızca hakemli dergilerde İngilizce olarak yayınlanan klinik araştırmalar değerlendirildi. Preoperatif ve postoperatif klinik skorların yanı sıra eklem hareket açıklığı (ROM) arasındaki karşılaştırma Wilcoxon-Mann-Whitney testi kullanılarak yapıldı. 0,05'in altındaki P değerleri istatistiksel olarak anlamlı kabul edildi
Bulgular: Çalışmamıza 12 makale dahil edildi. Ameliyat öncesi ve ameliyat sonrasında yapılan muayenelerde elde edilen sonuçlar karşılaştırıldığında eklem hareket açıklıklarında ve fonksiyonel skorlamalarda istatistiksel olarak anlamlı bir iyileşme olduğu görüldü. Hastaların %21.1’inde çeşitli komplikasyonlar geliştiği gözlendi. Komplikasyonların en sık görüleni hastaların %13,8'inde meydana gelen skapular çentiklenmedir. Hastaların %1.57'sinde revizyon ameliyatı gerekti. Revizyonun sık nedeninin periprostetik eklem enfeksiyonu olduğu görüldü.
Çıkarım: CTA hastalarında RSA ile hem ağrısız omuz eklemi hem de fonksiyonel olarak artış sağlanabilmektedir. Olumlu sonuçlarına karşın hastaların yaklaşık beşte birinde çeşitli şiddetlerde komplikasyon görülebilmektedir. Level I çalışmalarının olmayışı, CTA hastalarının tedavisinde RSA'nın potansiyelleri ve sınırlamalarının gerçek anlamda anlaşılmasını sınırlamaktadır.

Anahtar Kelimeler

Manşet yırtığı artropatisi, Ters omuz artroplastisi, Sonuçlar, Komplikasyonlar

Etik Beyan

Literatür taramasına dayanan sistematik bir derleme olduğu için etik kurul onayına gerek duyulmadı.

Teşekkür

Dr. Öğr. Üy. Mete Gedikbaş ve Dr. Utkan Sobay'a bu çalışma için literatür taramasındaki çabalarından dolayı teşekkür ederiz.

Kaynakça

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