A new study published within the Journal of Bone & Joint Surgery, has revealed a reverse shoulder replacement could be an effective and long-lasting solution, to irreparable rotator cuff tears.
Previously, concern has been raised over the durability of the procedure in patients under the age of 65. The findings of the study can now ease those concerns, providing orthopaedic surgeons a deeper understanding of the benefits of the procedure.
What is an irreparable rotator cuff tear?
Irreplaceable rotator cuff tears are the most problematic for orthopaedic surgeons to work on. There’s a lot of controversy and debate over which methods should be used to treat patients. So, what exactly is it?
Irreparable rotator cuff tears are massive tears which aren’t able to be treated with conventional methods. After the tendon is massively torn, the muscle starts to be replaced with scar tissue and fat. This in turn prevents the muscle from contracting enough to rotate the ball of the shoulder socket.
The symptoms vary between patients, though all typically experience a high level of pain. Treatment is decided based upon an individual’s specific symptoms, though surgery is often favoured for younger patients. While in the past there has been concern over the effectiveness of surgery in those under the age of 65, the latest study suggests it could be the best form of treatment moving forward.
Why is the study promising?
The study conducted by researchers from the University of Zurich, analysed 20 patients who had undergone a reverse total shoulder arthroplasty (RTSA) procedure. Their average age was 57, and each had been left with what is known as Pseudo paralysis; meaning they were unable to lift the affected arm.
While traditional shoulder replacements would prove ineffective for these patients, the RTSA method has shown to work well. This is because it uses different muscles, rather than placing an implant into the rotator cuff, to move the shoulder. Initially, this type of surgery was mainly carried out on older patients. However, due to advancements in the field, the method has been improved. This means younger patients can now benefit from long-lasting effects.
In the study, the 20 patients received follow-up assessments between 8-19 years after the reverse shoulder replacement was performed. Three of these patients had undergone a double reverse shoulder replacement, taking the total surgeries for the group to 23. An average Constant Score of 59 was recorded, up from 24 prior to surgery. This score was based upon strength, pain, motion and ability to perform daily tasks.
Complication rate higher in RTSA patients
The only negative shown in the research, was the increased risk of complications. Out of the 20 patients, six of them required a further surgery, while it failed completely in two of them. Complications were shown to affect 39% of patients.
However, despite the higher complication rate, 72% of the patients were happy with the results of the procedure.
While the complications do need to be factored in when deciding whether or not RTSA is right for a patient, this new research shows the results can hold up for a lot longer than previously thought. It is worth noting that there are several treatment options available, so RTSA may not be appropriate for all patients. If you think you are suffering with an irreparable rotator cuff tear, it is important to seek advice from a shoulder specialist prior to undergoing treatment. Call us on 0203 195 2442 to arrange a consultation.