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Should the supraspinatus tendon be excised in the case of reverse shoulder arthroplasty for fracture?

  • Original Article • SHOULDER - ARTHROPLASTY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

In the case of reverse shoulder arthroplasty (RSA) for proximal humeral fractures (PHFs) with tuberosity reconstruction, it is unclear whether the supraspinatus tendon continues to play a role. The aim of this study was to evaluate the clinical and radiological outcomes of RSA for PHFs in a large cohort of elderly patients and compare the results in the case of supraspinatus excision or preservation.

Methods

In this retrospective multicentre study, 150 patients (mean age 77 years, 93% female) were reviewed and radiographed with a minimum follow-up of 24 months. The same Grammont prosthetic design was used in all cases (inclination angle 155°, non-lateralised glenosphere). Patients were divided into two groups: Group A (n = 117) underwent supraspinatus excision and Group B supraspinatus preservation (n = 33). Complications were recorded, and shoulder function, active mobility and subjective results were assessed.

Results

At a mean follow-up of 59 months, there was no statistical difference in the complication rate (6% vs. 6.8%, p = 1), mean Constant score (61 points vs. 59 points, p = 0.52), simple shoulder value (74% vs. 73.9%, p = 0.9), active anterior elevation (125° vs. 128°, p = 0.45) and internal rotation (4.9 points vs. 4.1 points, p = 0.2). However, mean active external rotation was better in Group A (22° vs. 13°, p = 0.01). The greater tuberosity healing rate in satisfactory position did not differ statistically between the groups (68% vs. 55%, p = 0.14).

Conclusion

In the case of RSA with tuberosity reconstruction for acute PHFs, there is no clear evidence that supraspinatus preservation is advantageous.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Riquet Hospital, University of Toulouse, Toulouse, France

    Nicolas Bonnevialle

  2. Orthopaedic Department, University Hospital, Reims, France

    Xavier Ohl

  3. Shoulder and Elbow Service HUS - CCOM, Illkirch, France

    Philippe Clavert

  4. Trousseau University Hospital, Tours, France

    Luc Favard

  5. AERCOT, iULS, University Hospital Pasteur, Nice, France

    Anne Frégeac

  6. University Hospital, Besançon, France

    Laurent Obert

  7. North University, Lille, France

    Christophe Chantelot

  8. Saint Vincent Private Hospital, Besançon, France

    David Gallinet

  9. Department of Orthopaedic Surgery, iULS, University of Nice Sophia-Antipolis, Nice, France

    Pascal Boileau

Authors
  1. Nicolas Bonnevialle
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  2. Xavier Ohl
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  3. Philippe Clavert
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  4. Luc Favard
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  5. Anne Frégeac
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  6. Laurent Obert
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  7. Christophe Chantelot
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  8. David Gallinet
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  9. Pascal Boileau
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Corresponding author

Correspondence to Nicolas Bonnevialle.

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Conflict of interest

Nicolas Bonnevialle, Philippe Clavert, Luc Favard, Pascal Boileau received from Tornier Wright honorarium as consultant, Laurent Obert received from FX Solutions honorarium as consultant and Christophe Chantelot received from Evolutis honorarium as consultant. The other authors declare that they have no conflict of interest.

Ethical approval

Approved CCTIRS-16-003

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Informed consent was obtained from all individual participants included in the study.

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Bonnevialle, N., Ohl, X., Clavert, P. et al. Should the supraspinatus tendon be excised in the case of reverse shoulder arthroplasty for fracture?. Eur J Orthop Surg Traumatol 30, 231–235 (2020). https://doi.org/10.1007/s00590-019-02572-7

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  • DOI: https://doi.org/10.1007/s00590-019-02572-7

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