Results of Surgical Treatment of Patients with Stage II Rotator Cuff Arthropathy According to Hamada

Vollständiger Abstract

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Summary. Background. Surgical treatment of rotator cuff arthropathy (RCA) of the shoulder joint remains challenging and insufficiently studied because these patients develop biomechanical disorders in the shoulder joint associated with superior migration of the humeral head and fatty degeneration of the rotator cuff muscles. Objective. To compare the outcomes of different surgical treatment options in patients with Hamada stage II RCA. Materials and Methods. A total of 391 patients with RCA of varying severity were treated. Hamada stage II RCA was identified in 130 patients (33.2%); these patients were included in the present study. The mean age was 64.1 ± 19.4 years. The patients were divided into five groups according to the surgical procedure performed. Shoulder function was assessed using the Constant Shoulder Score and VAS before surgery and at 6 and 12 months postoperatively. Results. At 6 months, the best mean Constant Shoulder Score among all patients with Hamada stage II RCA was observed in the group where the upper capsule was restored (20.9 ± 14.3 points). Slightly poorer results were obtained in the group where reverse shoulder arthroplasty was performed (23.8 ± 5.1 points), whereas the poorest results were observed in the group where rotator cuff tendons were repaired (38.4 ± 12.1 points). Conclusions. The greatest mean increase in shoulder function according to the Constant Shoulder Score at 12 months after the surgery was observed in the group that underwent reverse shoulder arthroplasty and restoration of the upper capsule of the shoulder joint. The smallest mean increase in shoulder function according to the Constant Shoulder Score was observed in the group that underwent rotator cuff tendon repair or shoulder debridement. Based on these findings, these surgical procedures do not appear appropriate for patients with stage II RCA.