title: A combination of subscapularis tendon transfer and small-head hemiarthroplasty for cuff tear arthropathy: a pilot study.
abstract: This pilot study reports the clinical outcomes of a combination of partial subscapularis tendon transfer and small-head hemiarthroplasty in patients with rotatator cuff arthropathy. A total of 30 patients (30 shoulders; eight men and 22 women) with a mean age of 74 years (55 to 84) were assessed at a mean follow-up of 31 months (24 to 60). The inclusion criteria were painful cuff tear arthropathy with normal deltoid function and a non-degenerative subscapularis muscle and tendon and a preserved teres minor. Outcome was assessed using the University of California Los Angeles score, the Japanese Orthopaedic Association score, and the Oxford Shoulder Score. Radiographic measurements included the centre of rotation distance and the length of the deltoid. All clinical scores were significantly improved post-operatively. The active flexion and external rotation improved significantly at the most recent follow-up (p < 0.035). Although the mean centre of rotation distance changed significantly (p < 0.001), the mean length of the deltoid did not change significantly from the pre-operative value (p = 0.29). The change in the length of the deltoid with < 100° flexion was significantly less than that with > 100° (p < 0.001). Progressive erosion of the glenoid was seen in four patients. No patient required revision or further surgery. A combination of partial subscapularis tendon transfer and small-head hemiarthroplasty effectively restored function and relieved pain in patients with rotator cuff arthropathy.
authors.affiliation: Hokkaido University Graduate School of Medicine, Kita 15 Nishi 5, Sapporo, Hokkaido, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Urita
authors.affiliation: Hokkaido University Graduate School of Medicine, Kita 15 Nishi 5, Sapporo, Hokkaido, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Funakoshi
authors.affiliation: Hokushin Hospital, Sapporo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Suenaga
authors.affiliation: Hokushin Hospital, Sapporo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Oizumi
authors.affiliation: Hokkaido University Graduate School of Medicine, Kita 15 Nishi 5, Sapporo, Hokkaido, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Iwasaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome
keywords: Rotator cuff tear arthropathy; humeral head replacement; tendon transfer