Reverse Shoulder Arthroplasty for Management of Postinfectious Arthropathy With Rotator Cuff Deficiency.

Abstract

Treatment of patients with rotator cuff deficiency and arthritis in the setting of a prior glenohumeral infection (postinfectious arthropathy) is complex, with little evidence to guide treatment. The current authors present their approach to management of these patients and clinical outcomes after reverse shoulder arthroplasty (RSA). All primary RSAs performed for postinfectious arthropathy and rotator cuff deficiency with native glenohumeral joints were identified in a prospective shoulder arthroplasty registry. Eight patients with a minimum of 2-year follow-up were included in the analysis. Clinical outcomes, including the Constant score, the American Shoulder and Elbow Surgeons (ASES) score, the Western Ontario Osteoarthritis Shoulder (WOOS) index, the Single Assessment Numeric Evaluation (SANE) score, and range of motion measurements, were assessed preoperatively and at final follow-up. At an average follow-up of 4.4 years, no patient had a clinically detectable recurrence of infection. Significant improvements were noted in all outcome scores from preoperative evaluation to final follow-up after RSA, including Constant score (P=.003), ASES score (P<.001), WOOS index (P=.002), SANE score (P=.025), forward flexion (P<.001), abduction (P<.001), and external rotation (P=.020). Seven of 8 patients reported they were satisfied or very satisfied at final follow-up. Reverse shoulder arthroplasty can be performed in patients without significant medical comorbidities in the setting of postinfectious arthropathy and rotator cuff deficiency with a low risk of recurrence of infection. Significant clinical improvements were noted at short-term follow-up.