Massive irreparable rotator cuff tear and associated deltoid tear. Does the reverse shoulder arthroplasty and deltoid repair be a possible option of treatment?

Raffaele Garofalo, Brody Flanagin, Alessandro Castagna, Vittorio Calvisi, Sumant G. Krishnan

Research output: Contribution to journalArticlepeer-review

Abstract

Background and purpose Rupture of the anterior and middle deltoid muscle associated with rotator cuff tear arthropathy (RCA) could result in a definitive loss of shoulder function. The purpose of this study was to evaluate clinical outcomes after a concomitant reverse shoulder arthroplasty (RSA) and deltoid repair under these circumstances. Materials and methods Between 2006 and 2012, 18 consecutive patients with a mean age of 69.7 years, affected by massive irreparable rotator cuff tear and associated dehiscence or rupture of anterior and middle deltoid muscle underwent this operation through a modified anterosuperior approach. Four patients referred a previous shoulder surgery and deltoid tear was iatrogenic. The other 14 cases had an attritional deltoid tears. The average follow-up was 64 months (range 25–121 months). Results The mean active anterior elevation passed from a preoperative mean of 53 ± 9.1 (range 45–70) to 132.7 ± 11.6° (85–155°), active external rotation passed from a preoperative mean value of 22.4 ± 3.6° (range 18–26) to an average of 33.7 ± 4.7° (range 30–40°). Mean Constant score increased from 42 ± 6.1 (range 31–51) pre-operatively to 72.3 ± 8.2 (range 57–82) post-operatively. At final review, deltoid contour subjectively was satisfactory to all patients with no palpable defects. Conclusion RSA associated with a repair of deltoid tear could be a viable surgical option in cases of tear involving the anterior and middle deltoid associated with a RCA. Patient with a preoperative chronic axillary nerve neuropathy associated with a deltoid muscle tear should be cautioned about the possibility of lower functional outcomes.

Original languageEnglish
Pages (from-to)753-758
Number of pages6
JournalJournal of Orthopaedic Science
Volume21
Issue number6
DOIs
Publication statusPublished - Nov 1 2016

ASJC Scopus subject areas

  • Medicine(all)
  • Orthopedics and Sports Medicine

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