Psuedoparalysis associated with failed rotator cuff repair, progression to RSA

ByMax R. Wursta

Fact checked byGina Brockenbrough, MA

Key takeaways:

Patients with pseudoparalysis are likely to fail index rotator cuff repair and require reverse shoulder arthroplasty.
These patients may be better served by initial management with reverse shoulder arthroplasty.

LAS VEGAS — Presented results found a significant association between patients with pseudoparalysis and failed index rotator cuff repair and subsequent reverse shoulder arthroplasty.

“In the case of a failed rotator cuff repair (RCR), it is not pleasant,” Michael L. Pearl, MD, said in his presentation at the American Shoulder and Elbow Surgeons Specialty Day during the American Academy of Orthopaedic Surgeons Annual Meeting. “[These patients] have extended periods of pain, arduous unsuccessful rehabilitation and the entire experience represents an extreme economic burden on the health care system,” he added.

Shoulder pain — Patients with pseudoparalysis are likely to fail index rotator cuff repair and require reverse shoulder arthroplasty. *Image: Adobe Stock*

Michael L. Pearl

Of 573 RSAs performed for rotator cuff arthropathy from 2010 to 2015, Pearl and colleagues at Southern California Permanente Medical Group analyzed 39 patients who underwent 42 RSAs after a failed index RCR. Median time from index RCR to RSA was 15.5 months, according to the study abstract.

Compared with patients who underwent primary RSA, patients who underwent RSA after failed RCR were more likely to be younger (74.3 vs. 70.2 years of age) and female (65.2% vs. 81%). Researchers also found 50% of patients who underwent RSA after failed RCR had pseudoparalysis at the time of index RCR, thus Pearl concluded pseudoparalysis was a significant risk factor for failed RCR and progression to RSA.

Patients with these “unfavorable characteristics” may be better served with an initial, primary RSA, Pearl and colleagues noted in the abstract.

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Sources/Disclosures

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Source:

Pearl ML, et al. Failed rotator cuff surgery that led to reverse total shoulder arthroplasty: Can we predict who will fail? Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 7-11, 2023; Las Vegas.

Disclosures: Pearl reports being a board or committee member for the American Shoulder and Elbow Surgeons.

American Academy of Orthopaedic Surgeons Annual Meeting

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Psuedoparalysis associated with failed rotator cuff repair, progression to RSA

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