title: Postoperative rupture of the anterolateral deltoid muscle following reverse total shoulder arthroplasty in patients who have undergone open rotator cuff repair.
abstract: BACKGROUND
  Postoperative ruptures of the antero-lateral deltoid in patients with reverse total shoulder arthroplasty utilizing the delto-pectoral approach following failed mini-open or open rotator cuff repairs have not been reported in the English literature. The incidence of this complication is unknown.
  
  
  METHODS
  A retrospective review of 199 patients who underwent reverse total shoulder arthroplasty utilizing a deltopectoral approach was performed. These procedures were performed by 2 surgeons in 2 hospitals. There were 3 patients who had postoperative rupture of the deltoid. These ruptures occurred without any history of trauma to the patient. In all 3 patients, past surgical history was significant for a rotator cuff repair utilizing a mini-open or mini-open modified to open approach. Successful repair of the deltoid was achieved using a transosseous suture repair in all 3 patients.
  
  
  RESULTS
  At most current follow-up (all >12 months), average forward elevation was 120°. A small residual anterior deltoid defect was present in all 3 patients, but pain was quantified as 0-4 out of 10 and radiographs demonstrated satisfactory position of the reverse arthroplasty implants.
  
  
  CONCLUSIONS
  Postoperative ruptures of the antero-lateral deltoid can occur in patients who have undergone reverse total shoulder arthroplasty, utilizing the delto-pectoral approach following failed mini-open or open rotator cuff repairs. A supero-lateral approach during reverse total shoulder arthroplasty could be useful in assessing and possibly reinforcing a deltoid origin previously damaged or repaired during mini-open or open rotator cuff repair.
authors.affiliation: Brigham and Women's Hospital, Boston, MA ,USA.
authors.forename: Adam N
authors.initials: AN
authors.lastname: Whatley
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Fowler
authors.forename: Jon J P
authors.initials: JJ
authors.lastname: Warner
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Higgins
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D057645:Deltoid Muscle / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012422:Rupture, Spontaneous; D012785:Shoulder Joint / Q000601:surgery*