Clinical outcome of reverse total shoulder arthroplasty (comprehensive system) after failed rotator cuff repair with a medium-term follow-up: comparison with reverse total shoulder arthroplasty for massive rotator cuff tear without osteoarthritis.

Background: We compared the clinical outcomes of primary reverse total shoulder arthroplasty (rTSA) in patients with massive rotator cuff tears (mRCTs) without osteoarthritis (OA), secondary rTSA in patients with failed rotator cuff repair (RCR), and primary rTSA in patients with cuff tear arthropathy (CTA) as a control group. Methods: Among 364 patients who underwent rTSA between March 2014 and August 2019, 153 were included. All patients underwent surgery with a single implant type and were followed for a minimum of 4 years. Patients were categorized into three groups: primary rTSA for mRCT without OA (mRCT group, n = 24), primary rTSA for CTA (CTA group, n = 104), and rTSA for failed rotator cuff repair group (fRCR; fRCR group, n = 25). The mean age was 71.5 ± 6.3 (range, 53-83) years, with a mean follow-up of 54.7 ± 12.9 (range, 48-98) months. Functional outcomes were assessed using the active range of motion, the visual analog scale for pain, the simple shoulder test, the American Shoulder and Elbow Surgeons score, the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score, and the Constant score at the final follow-up. Results: All functional outcomes significantly improved postoperatively in each group ( Conclusion: Considering the worse clinical outcomes of secondary rTSA after failed RCR compared to primary rTSA for mRCT without OA and/or CTA, careful selection of appropriate candidates for RCR or primary rTSA as a treatment option for mRCT without OA is essential, according to their healing potential.