title: The influence of rotator cuff pathology on functional outcome in total shoulder replacement.
abstract: BACKGROUND
  Total shoulder replacement (TSR) is a reliable treatment for glenohumeral osteoarthritis. In addition to proper component orientation, successful arthroplasty requires accurate restoration of soft tissues forces around the joint to maximize function. We hypothesized that pathological changes within the rotator cuff on preoperative magnetic resonance imaging (MRI) adversely affect the functional outcome following TSR.
  
  
  METHODS
  A retrospective analysis of case notes and MRI of patients undergoing TSR for primary glenohumeral osteoarthritis over a 4-year period was performed. Patients were divided into three groups based upon their preoperative MRI findings: (1) normal rotator cuff, (2) the presence of tendonopathy within the rotator cuff, or (3) the presence of a partial thickness rotator cuff tear. Intra-operatively tendonopathy was addressed with debridement and partial thickness tears with repair. Functional outcome was assessed with the Oxford Shoulder Score (OSS), and quick disabilities of the arm, shoulder and hand score (quick-DASH).
  
  
  RESULTS
  We had a full dataset of complete case-notes, PACS images, and patient reported outcome measures available for 43 patients, 15 in group 1, 14 in group 2, and 14 in group 3. Quick-DASH and OSS were calculated at a minimum of 24 months following surgery. There was no statistically significant difference between the results obtained between the three groups of either the OSS (P = 0.45), or quick-DASH (P = 0.46).
  
  
  CONCLUSIONS
  TSR is an efficacious treatment option for patients with primary glenohumeral osteoarthritis in the medium term, even in the presence of rotator cuff tendonopathy or partial tearing. Minor changes within the cuff do not significantly affect functional outcome following TSR.
authors.affiliation: Department of Orthopaedic Surgery, Level 5 Queens Building, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom.
authors.forename: Nathanael
authors.initials: N
authors.lastname: Ahearn
authors.affiliation: Department of Orthopaedic Surgery, Level 5 Queens Building, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom.
authors.forename: Philip A
authors.initials: PA
authors.lastname: McCann
authors.affiliation: Department of Orthopaedic Surgery, Level 5 Queens Building, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tasker
authors.affiliation: Department of Orthopaedic Surgery, Level 5 Queens Building, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom.
authors.forename: Partha P
authors.initials: PP
authors.lastname: Sarangi
keywords: MRI; outcome measures; rotator cuff; total shoulder replacement