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Subscapularis-sparing TSA offers shoulder anatomic restoration, long-term outcomes raise concerns
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Using subscapularis-sparing total shoulder arthroplasty offered anatomic restoration of the shoulder; however, concerns were raised with regard to long-term outcomes due to retained osteophytes and significantly mismatched humeral head diameter, according to researchers’ findings.
The researchers conducted a prospective, randomized trial with 96 patients who underwent total shoulder arthroplasty (TSA): 46 patients (mean age: 69 years) were randomly assigned to undergo TSA utilizing the subscapularis-sparing approach, and 50 patients (mean age: 67 years) underwent standard TSA. Postoperative radiographs were immediately performed on all patients.
Within 6 weeks after surgery, two blinded independent reviewers evaluated postoperative anteroposterior and axillary radiographs. The researchers obtained anatomic reconstruction measurements for humeral head height, humeral head centering, humeral head medial offset, humeral head diameter (HHD), head-neck angle and residual osteophytes. Additionally, anatomic reconstruction index (ARI) was calculated.
No significant differences existed between the groups with regard to age, sex, BMI or operative side, according to the researchers. Additionally, the subscapularis-sparing group did not have significantly different operative times compared with the standard TSA group, at 117 minutes vs. 124 minutes, respectively.
According to the researchers, differences were not significant between the groups for humeral head height, humeral head centering, humeral head medial offset, HHD, head-neck angle and ARI; however, residual osteophytes significantly increased in the subscapularis-sparing group.
Nine patients in the subscapularis-sparing group demonstrated a humeral head discrepancy of 4 mm compared with four patients in the standard TSA group, even though differences were not significant for mean values, the researchers reported. – by Monica Jaramillo
Disclosures: Ding reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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