Complication rates, dislocation, pain, and postoperative range of motion after reverse shoulder arthroplasty in patients with and without repair of the subscapularis

J Shoulder Elbow Surg. 2012 Jan;21(1):36-41. doi: 10.1016/j.jse.2011.04.009. Epub 2011 Jul 31.

Abstract

Background: Despite improved results with reverse shoulder arthroplasty (RSA), questions still remain regarding certain technical aspects of the operation. One particular area of question is the effect of subscapularis repair on complication rates, dislocation, pain, and overall range of motion. Some authors suggest that when a deltopectoral approach is used, not repairing the subscapularis leads to a higher complication rate, especially for dislocation.

Materials and methods: From a reverse total shoulder arthroplasty database of 3 surgeons at 1 institution, we identified 55 patients who underwent RSA using the deltopectoral approach without subscapularis repair and 65 patients with subscapularis repair.

Results: Complications were documented in 11 of 55 shoulders (20%) without subscapularis repair and in 13 of 65 shoulders (20%) with subscapularis repair. Dislocation occurred in 3 shoulders in the nonrepair group and in 2 shoulders in the repair group. These data indicate that nonrepair of the subscapularis did not have a significant effect on the risk of any complication, dislocation, infection, disassociation, or function.

Conclusion: Repairing the subscapularis has no appreciable effect on complication rate, dislocation events, or range of motion gains and pain relief.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthroplasty / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Pain, Postoperative / epidemiology*
  • Pain, Postoperative / etiology
  • Pain, Postoperative / physiopathology
  • Postoperative Complications
  • Range of Motion, Articular*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Rotator Cuff*
  • Shoulder Dislocation / epidemiology*
  • Shoulder Dislocation / etiology
  • Shoulder Dislocation / physiopathology
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery*
  • United States / epidemiology