This Article Full Text Full Text (PDF) Letters to the Editor: Submit a response Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Reprints and Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Werner, C.M.L. Articles by Gerber, C. Search for Related Content PubMed PubMed Citation Articles by Werner, C.M.L. Articles by Gerber, C. Social Bookmarking             What's this?

Treatment of Painful Pseudoparesis Due to Irreparable Rotator Cuff Dysfunction with the Delta III Reverse-Ball-and-Socket Total Shoulder Prosthesis

¹ Department of Orthopaedics, University of Zürich, Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland. E-mail address for C. Gerber: christian.gerber{at}balgrist.ch

Investigation performed at the Department of Orthopaedics, University of Zürich, Balgrist, Zürich, Switzerland

Methods: Fifty-eight consecutive patients with moderate-to-severe shoulder pain and active anterior elevation of <90° due to an irreparable rotator cuff tear were treated with a Delta III total shoulder replacement at an average age of sixty-eight years. Seventeen of the procedures were the primary treatment for the shoulder, and forty-one were revisions. The patients were examined clinically and radiographically after an average duration of follow-up of thirty-eight months.

Results: On the average, the subjective shoulder value increased from 18% preoperatively to 56% postoperatively (p < 0.0001); the relative Constant score, from 29% to 64% (p < 0.0001); the Constant score for pain, from 5.2 to 10.5 points (p < 0.0001); active anterior elevation, from 42° to 100° (p < 0.0001); and active abduction, from 43° to 90° (p < 0.0001). The patients for whom the implantation of the Delta III prosthesis was the primary procedure and those who had had previous surgery showed similar amounts of improvement. The total complication rate, including all minor complications, was 50%, and the reoperation rate was 33%. Of the seventeen primary operations, 47% (eight) were associated with a complication and 18% (three) were followed by a reoperation. Of the forty-one revisions, 51% (twenty-one) were associated with a complication and 39% (sixteen) were followed by a reoperation. Subjective results and satisfaction rates were not influenced by complications or reoperations when the prosthesis had been retained.

Conclusions: Total shoulder arthroplasty with the Delta III prosthesis is a salvage procedure for severe shoulder dysfunction caused by an irreparable rotator cuff tear associated with other glenohumeral lesions. Complications were frequent following both primary and revision procedures, but they rarely affected the final outcome. The procedure has a substantial potential to improve the condition of patients with severe shoulder dysfunction, at least in the short term.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?

This article has been cited by other articles:

				J. M. Wiater and M. H. Fabing Shoulder Arthroplasty: Prosthetic Options and Indications J. Am. Acad. Ortho. Surg., July 1, 2009; 17(7): 415 - 425. [Abstract] [Full Text] [PDF]

				C. Gerber, S. D. Pennington, and R. W. Nyffeler Reverse Total Shoulder Arthroplasty J. Am. Acad. Ortho. Surg., May 1, 2009; 17(5): 284 - 295. [Abstract] [Full Text] [PDF]

				P. M. Tonino, C. Gerber, E. Itoi, G. Porcellini, D. Sonnabend, and G. Walch Complex Shoulder Disorders: Evaluation and Treatment J. Am. Acad. Ortho. Surg., March 1, 2009; 17(3): 125 - 136. [Abstract] [Full Text] [PDF]

				S. Gutierrez, C. A. Comiskey IV, Z.-P. Luo, D. R. Pupello, and M. A. Frankle Range of Impingement-Free Abduction and Adduction Deficit After Reverse Shoulder Arthroplasty. Hierarchy of Surgical and Implant-Design-Related Factors J. Bone Joint Surg. Am., December 1, 2008; 90(12): 2606 - 2615. [Abstract] [Full Text] [PDF]

				D. Cuff, D. Pupello, N. Virani, J. Levy, and M. Frankle Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency J. Bone Joint Surg. Am., June 1, 2008; 90(6): 1244 - 1251. [Abstract] [Full Text] [PDF]

				F. A. Matsen III Rotator-Cuff Failure N. Engl. J. Med., May 15, 2008; 358(20): 2138 - 2147. [Full Text] [PDF]

				S. S. Goldberg, J.-E. Bell, H. J. Kim, S. F. Bak, W. N. Levine, and L. U. Bigliani Hemiarthroplasty for the Rotator Cuff-Deficient Shoulder J. Bone Joint Surg. Am., March 1, 2008; 90(3): 554 - 559. [Abstract] [Full Text] [PDF]

				P.O. Zingg, B. Jost, A. Sukthankar, M. Buhler, C.W.A. Pfirrmann, and C. Gerber Clinical and Structural Outcomes of Nonoperative Management of Massive Rotator Cuff Tears J. Bone Joint Surg. Am., September 1, 2007; 89(9): 1928 - 1934. [Abstract] [Full Text] [PDF]

				B. Wall, L. Nove-Josserand, D. P. O'Connor, T. B. Edwards, and G. Walch Reverse Total Shoulder Arthroplasty: A Review of Results According to Etiology J. Bone Joint Surg. Am., July 1, 2007; 89(7): 1476 - 1485. [Abstract] [Full Text] [PDF]

				R. W. Simovitch, N. Helmy, M. A. Zumstein, and C. Gerber Impact of Fatty Infiltration of the Teres Minor Muscle on the Outcome of Reverse Total Shoulder Arthroplasty J. Bone Joint Surg. Am., May 1, 2007; 89(5): 934 - 939. [Abstract] [Full Text] [PDF]

				C. Gerber, S. D. Pennington, E. J. Lingenfelter, and A. Sukthankar Reverse Delta-III Total Shoulder Replacement Combined with Latissimus Dorsi Transfer. A Preliminary Report J. Bone Joint Surg. Am., May 1, 2007; 89(5): 940 - 947. [Abstract] [Full Text] [PDF]

				P. Boileau, F. Baque, L. Valerio, P. Ahrens, C. Chuinard, and C. Trojani Isolated Arthroscopic Biceps Tenotomy or Tenodesis Improves Symptoms in Patients with Massive Irreparable Rotator Cuff Tears J. Bone Joint Surg. Am., April 1, 2007; 89(4): 747 - 757. [Abstract] [Full Text] [PDF]

				R. W. Simovitch, M. A. Zumstein, E. Lohri, N. Helmy, and C. Gerber Predictors of Scapular Notching in Patients Managed with the Delta III Reverse Total Shoulder Replacement J. Bone Joint Surg. Am., March 1, 2007; 89(3): 588 - 600. [Abstract] [Full Text] [PDF]

				F. A. Matsen III, P. Boileau, G. Walch, C. Gerber, and R. T. Bicknell The Reverse Total Shoulder Arthroplasty J. Bone Joint Surg. Am., March 1, 2007; 89(3): 660 - 667. [Full Text] [PDF]

				C. A. Rockwood Jr. The Reverse Total Shoulder Prosthesis. The New Kid on the Block J. Bone Joint Surg. Am., February 1, 2007; 89(2): 233 - 235. [Full Text] [PDF]

				C. C. Roberts, A. L. Ekelund, K. J. Renfree, P. T. Liu, and F. S. Chew Radiologic Assessment of Reverse Shoulder Arthroplasty RadioGraphics, January 1, 2007; 27(1): 223 - 235. [Abstract] [Full Text] [PDF]

				K. I. Bohsali, M. A. Wirth, and C. A. Rockwood Jr. Complications of Total Shoulder Arthroplasty J. Bone Joint Surg. Am., October 1, 2006; 88(10): 2279 - 2292. [Full Text] [PDF]

				M. Frankle, J. C. Levy, D. Pupello, S. Siegal, A. Saleem, M. Mighell, and M. Vasey The Reverse Shoulder Prosthesis for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency. A Minimum Two-Year Follow-up Study of Sixty Patients Surgical Technique J. Bone Joint Surg. Am., September 1, 2006; 88(1_suppl_2): 178 - 190. [Abstract] [Full Text] [PDF]

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2005 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.