This is an important study describing the experience of a single surgeon in dealing with the difficult problem of cuff tear arthropathy using a reverse shoulder implant. Many previous studies have included a variety of different diagnoses, but this work concentrates solely on the indication for which this design of implant was primarily intended. The authors describe in meticulous detail their preferred surgical technique, and they prospectively followed their patients using both preoperative and postoperative outcome scores. The follow-up of the 50 cases averaged nearly four years with 98% capture which is impressive. There were substantial improvements in outcome scores and active range of motion, with a mean increase of 50° in elevation alone. The complication rate of 14% is acceptably low when compared with other series and only 8% required a further operation. This paper provides good evidence that reverse shoulder arthroplasty is an excellent option in the elderly patient with cuff tear arthropathy.
by Mr A.L.Wallace
Hospital of St John & St Elizabeth, London