Rotator Cuff Dysfunction After Anatomic Total Shoulder Arthroplasty: Who Is at Risk?


We compare post-total shoulder arthroplasty (TSA) patients with suspected cuff dysfunction to a successful-TSA control group. Thirty-nine patients met suspected-cuff -dysfunction criteria. Forty matched controls were selected. Radiographic and functional outcomes and demographics were compared preoperatively and postoperatively. Humeral head height above the greater tuberosity and postoperative humeral head translations were signifi cantly greater in the dysfunction group. The dysfunction group demonstrated a signifi cant correlation between higher humeral heads and earlier postoperative dysfunction, signifi cantly more glenoid radiolucencies, and signifi cant defi cits in active and passive forward elevation. External rotation did not diff er signifi cantly until the fi nal follow up. Functional scores diff ered signifi cantly by 6 months, with the exception of the 1-year American Shoulder and Elbow Surgeons score. Post-TSA cuff dysfunction leads to worse functional scores, worse range of motion, and more glenoid radiolucencies. Proper patient selection and humeral head placement may prevent this. Early postoperative forward-elevation stiff ness may portend dysfunction. (Journal of Surgical Orthopaedic Advances 29(1):31-35, 2020) Keywords: anatomic total shoulder arthroplasty, cuff dysfunction, functional scores, glenoid radiolucent lines, rotator cuff tear, stiff ness

Stephen T. Ikard, Jr., MD; Kevin W. Farmer, MD; Aimee M. Struk, MEd, ATC; Cynthia S. Garvan, PhD; Alexandra Gillespy Lorentsen, MD; and Thomas W. Wright, MD