title: Primary reverse total shoulder arthroplasty outcomes in patients with subscapularis repair versus tenotomy.
abstract: BACKGROUND
  Reverse total shoulder arthroplasty (RTSA) is now performed at nearly the same rate as anatomic total shoulder arthroplasty in the United States. Repair of the subscapularis is of vital importance in total shoulder arthroplasty; however, its utilization in RTSA has recently been questioned.
  
  
  METHODS
  This is a retrospective comparative study from prospectively collected data comparing the outcomes and complications after primary RTSA with or without subscapularis repair. The study includes 202 patients who underwent primary RTSA at a single institution by a single surgeon using the same implant between 2007 and 2012. Average clinical follow-up was greater than 3 years in both groups. Outcome scores, clinical range-of-motion and strength measurements, and complications including dislocations are reported.
  
  
  RESULTS
  At an average follow-up of greater than 3 years, there were no significant differences in clinical range of motion, strength, and rates of complications including dislocations. External rotation was 24° in the subscapularis repair group and 26° in the no-repair group. There were no differences in the American Shoulder and Elbow Surgeons shoulder score. Subjective measures included the Shoulder Pain and Disability Index; University of California, Los Angeles shoulder rating scale; Simple Shoulder Test; and normalized Constant outcome scores. There were 0 dislocations (0%) in the subscapularis repair group and 3 dislocations in the no-repair group (2.6%), which were not significantly different.
  
  
  CONCLUSIONS
  Primary RTSAs with or without subscapularis repair have similar clinical outcome scores, range of motion, strength, and rates of complications including dislocations at 3 years of follow-up.
authors.affiliation: Ortho El Paso, El Paso, TX, USA. Electronic address: jvourazeris@orthoep.com.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Vourazeris
authors.affiliation: Orthopaedics and Sports Medicine Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Wright
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA.
authors.forename: Aimee M
authors.initials: AM
authors.lastname: Struk
authors.affiliation: Orthopaedics and Sports Medicine Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: King
authors.affiliation: Orthopaedics and Sports Medicine Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Farmer
mesh_terms: D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053580:Muscle Strength; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012399:Rotation; D012783:Shoulder Dislocation / Q000209:etiology; D012785:Shoulder Joint / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D058971:Tenotomy
keywords: Clinical outcome; dislocation; dislocations; range of motion; reverse total shoulder arthroplasty; subscapularis repair