Patients with better preoperative function may experience poor outcomes after RSA
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Results showed patients with higher preoperative single assessment numeric evaluation scores who undergo reverse shoulder arthroplasty for massive rotator cuff tears without glenohumeral arthritis have an increased risk for poor function.
Jacob M. Kirsch, MD, and colleagues performed a retrospective case-control study on 60 patients (mean age of 71.4 years) who underwent RSA for massive rotator cuff tears without glenohumeral arthritis and a mean follow-up of 30 months. Outcome measures included preoperative and postoperative single assessment numeric evaluation (SANE) scores, American Shoulder and Elbow Surgeons (ASES) scores and simple shoulder test (SST) scores.
According to the study, 30% of patients (n = 18) met the definition for poor outcomes based on preoperative risk factors. These patients defined the case group. The remaining 42 patients defined the control group.
Compared with the control group, the case group had worse postoperative SANE scores (61.6 vs. 84.9 in the control group), ASES scores (58.9 vs 82.2 in the control group) and SST scores (5.4 vs. 8.5 in the control group). The case group also a worse change from preoperative to postoperative scores in all three measures.
Additionally, patients with poor outcomes had “significantly higher” preoperative SANE scores compared with control group, the researchers noted.
“The results of this study show that higher preoperative SANE scores are associated with a greater likelihood of poor outcomes after RSA for massive rotator cuff tears without glenohumeral arthritis,” the researchers wrote in the study. “For these patients, alternative treatment options should be considered,” they added.
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