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SURGICAL MANAGEMENT OF ROTATOR CUFF ARTHROPATHY. A CASE COMPARISON STUDY

Rotator cuff arthropathy is characterised by pain and loss of function. Surgical management of the condition is difficult and controversial.

We have conducted a direct comparison between two shoulder replacement systems with different design rationales specifically recommended for the management of rotator cuff arthropathy.

15 patients who had previously undergone bipolar shoulder replacements (BIOMET) were matched for sex and age with patients who underwent DELTA reverse geometry shoulder replacements (DEPUY). All patients in this study were over 70 years old and had rotator cuff arthropathy with pain as their primary complaint and with a maximum active elevation of their arm of 50°. Patients were assessed clinically and radiologically, preoperatively in the 12 months after surgery.

All patients benefited from surgery with regard to pain relief, but the improvement as measured on the visual analogue scale was greater in those with the reverse geometry group (p<0.05). Active range of movements was only marginally improved in the bipolar group. However there was a marked improvement in the reverse geometry group with 14 out of 15 patients able to actively elevate their arm about shoulder height. This was a highly statistically significant finding (p<0.01).

This case comparison study strongly supports the reverse geometry design rationale over the bipolar design for the management of rotator cuff arthropathy in the elderly.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.