Influencing factors on effectiveness of reverse total shoulder arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Xuemiao , LIU Chao , LI Zhi , TIAN Kang ,  LI Jie

Department of Joint Surgery and Sports Medicine, the First Affiliated Hospital of Dalian Medical University, Dalian Liaoning, 116000, P. R. China;

Corresponding author：

LI Jie, Email: lijie7107@163.com

Keywords：

Shoulder joint; reverse total shoulder arthroplasty; effectiveness; influencing factor

DOI：

10.7507/1002-1892.202310088

Video：

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Objective To summarize the influencing factors on the effectiveness of reverse total shoulder arthroplasty (RTSA), so as to provide reference for clinical treatment. Methods The related research literature of RTSA at home and abroad was extensively consulted, and the factors that may affect the effectiveness were summarized from the aspects of surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. Results For surgical techniques, different surgical approaches have their own advantages. The glenoid notch, poor bone ingrowth, increased bone resorption, and infection would lead to the loosening of glenoid prosthesis. In addition, the neck shaft angle and inclination angle of humeral prosthesis affect the occurrence of glenoid notch and the range of motion of joint internal/external rotation after operation, respectively. For muscle condition, the quality of teres minor and deltoid muscle has an important influence on joint stability after operation. Moderate increase of deltoid muscle tension can improve joint mobility after operation, and suture repair of subscapular tendon during operation can relieve joint pain and improve function, range of motion, and strength. For the general condition of patients, gender, age, and body mass index are all related to postoperative joint function and complications, and different occupations and postoperative exercise levels affect the recovery. The patients with severe degenerative diseases, poor preoperative function, and long disease duration have lower expectations and higher satisfaction with the effectiveness, and bad lifestyle has a negative impact on the effectiveness. Conclusion The effectiveness of RTSA is related to surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. In order to avoid the loosening of glenoid prosthesis, the operator should choose humeral prosthesis with small neck shaft angle and large glenoid ball and put them down and inclined inferiorly during operation, and choose appropriate approach to eliminate space with drainage to reduce the risk of infection. After operation, patients should avoid activities that generate high anterior and posterior shear forces. In addition, the humeral prosthesis with a inclination angle of 10°-20° can achieve the best balance between the range of internal rotation and external rotation after operation. Proper deltoid tension can maintain joint stability and good range of motion. Suture of subscapular tendon is recommended.

Citation： LIU Xuemiao, LIU Chao, LI Zhi, TIAN Kang, LI Jie. Influencing factors on effectiveness of reverse total shoulder arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(2): 211-217. doi: 10.7507/1002-1892.202310088 Copy

1.	Thon SG, Seidl AJ, Bravman JT, et al. Advances and update on reverse total shoulder arthroplasty. Curr Rev Musculoskelet Med, 2020, 13(1): 11-19.
2.	Kozak T, Bauer S, Walch G, et al. An update on reverse total shoulder arthroplasty: current indications, new designs, same old problems. EFORT Open Rev, 2021, 6(3): 189-201.
3.	Collin P, Hervé A, Walch G, et al. Mid-term results of reverse shoulder arthroplasty for glenohumeral osteoarthritis with posterior glenoid deficiency and humeral subluxation. J Shoulder Elbow Surg, 2019, 28(10): 2023-2030.
4.	Viswanath A, Bale S, Trail I. Reverse total shoulder arthroplasty for irreparable rotator cuff tears without arthritis: A systematic review. J Clin Orthop Trauma, 2021, 17: 267-272.
5.	Rugg CM, Coughlan MJ, Lansdown DA. Reverse total shoulder arthroplasty: biomechanics and indications. Curr Rev Musculoskelet Med, 2019, 12(4): 542-553.
6.	Lee DH, Choi YS, Potter HG, et al. Reverse total shoulder arthroplasty: an imaging overview. Skeletal Radiol, 2020, 49(1): 19-30.
7.	Molé D, Favard L. Excentered scapulohumeral osteoarthritis. Rev Chir Orthop Reparatrice Appar Mot, 2007, 93(6 Suppl): 37-94.
8.	Gustas-French C, Petscavage-Thomas J, Bernard SA. Imaging of shoulder arthroplasties. AJR Am J Roentgenol, 2018, 211(3): 485-495.
9.	Molé D, Wein F, Dézaly C, et al. Surgical technique: the anterosuperior approach for reverse shoulder arthroplasty. Clin Orthop Relat Res, 2011, 469(9): 2461-2468.
10.	Boileau P. Complications and revision of reverse total shoulder arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S33-S43.
11.	Jang YH, Lee JH, Kim SH. Effect of scapular notching on clinical outcomes after reverse total shoulder arthroplasty. Bone Joint J, 2020, 102-B(11): 1438-1445.
12.	Kempton LB, Balasubramaniam M, Ankerson E, et al. A radiographic analysis of the effects of glenosphere position on scapular notching following reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2011, 20(6): 968-974.
13.	Kelly JD, Humphrey CS, Norris TR. Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part One: The twelve-mm rule. J Shoulder Elbow Surg, 2008, 17(4): 589-594.
14.	Kontaxis A, Johnson GR. The biomechanics of reverse anatomy shoulder replacement—a modelling study. Clin Biomech (Bristol, Avon), 2009, 24(3): 254-260.
15.	Nyffeler RW, Werner CM, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta Ⅲ total shoulder prosthesis. J Shoulder Elbow Surg, 2005, 14(5): 524-528.
16.	Lawrence C, Williams GR, Namdari S. Influence of glenosphere design on outcomes and complications of reverse arthroplasty: A systematic review. Clin Orthop Surg, 2016, 8(3): 288-297.
17.	柳金浪, 段志豪, 周游. 反式全肩关节置换的研究进展. 中国矫形外科杂志, 2021, 29(22): 2063-2066.
18.	Frank JK, Siegert P, Plachel F, et al. The evolution of reverse total shoulder arthroplasty-from the first steps to novel implant designs and surgical techniques. J Clin Med, 2022, 11(6): 1512.
19.	Pilliar RM, Lee JM, Maniatopoulos C. Observations on the effect of movement on bone ingrowth into porous-surfaced implants. Clin Orthop Relat Res, 1986, (208): 108-113.
20.	Zhang M, Junaid S, Gregory T, et al. Effect of baseplate positioning on fixation of reverse total shoulder arthroplasty. Clin Biomech (Bristol, Avon), 2019, 62: 15-22.
21.	Fávaro RC, Abdulahad M, Filho SM, et al. Rotator cuff arthropathy: what functional results can be expected from reverse arthroplasty? Rev Bras Ortop, 2015, 50(5): 523-529.
22.	Farshad M, Gerber C. Reverse total shoulder arthroplasty-from the most to the least common complication. Int Orthop, 2010, 34(8): 1075-1082.
23.	Franceschi F, Giovannetti de Sanctis E, Gupta A, et al. Reverse shoulder arthroplasty: State-of-the-art. J ISAKOS, 2023, 8(5): 306-317.
24.	韩晓珺, 戚文潇, 方朝毅, 等. 反置式全肩关节置换术治疗巨大不可修复性肩袖损伤研究进展. 国际骨科学杂志, 2017, 38(6): 341-344.
25.	Weston M, Gandhi MJ, Henning S, et al. Reverse shoulder arthroplasty for non-traumatic problems. Orthopaedics and Trauma, 2018, 32(3): 178-185.
26.	Gulotta LV, Choi D, Marinello P, et al. Humeral component retroversion in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elbow Surg, 2012, 21(9): 1121-1127.
27.	Henninger HB, Barg A, Anderson AE, et al. Effect of deltoid tension and humeral version in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elbow Surg, 2012, 21(4): 483-490.
28.	Virani NA, Cabezas A, Gutiérrez S, et al. Reverse shoulder arthroplasty components and surgical techniques that restore glenohumeral motion. J Shoulder Elbow Surg, 2013, 22(2): 179-187.
29.	Gutiérrez S, Comiskey CA, Luo ZP, et al. Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors. J Bone Joint Surg (Am), 2008, 90(12): 2606-2615.
30.	Erickson BJ, Frank RM, Harris JD, et al. The influence of humeral head inclination in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg, 2015, 24(6): 988-993.
31.	Constant CR, Gerber C, Emery RJ, et al. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg, 2008, 17(2): 355-361.
32.	Rhee YG, Cho NS, Moon SC. Effects of humeral component retroversion on functional outcomes in reverse total shoulder arthroplasty for cuff tear arthropathy. J Shoulder Elbow Surg, 2015, 24(10): 1574-1581.
33.	Stephenson DR, Oh JH, McGarry MH, et al. Effect of humeral component version on impingement in reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2011, 20(4): 652-658.
34.	Berhouet J, Garaud P, Favard L. Influence of glenoid component design and humeral component retroversion on internal and external rotation in reverse shoulder arthroplasty: a cadaver study. Orthop Traumatol Surg Res, 2013, 99(8): 887-894.
35.	Yoon JP, Seo A, Kim JJ, et al. Deltoid muscle volume affects clinical outcome of reverse total shoulder arthroplasty in patients with cuff tear arthropathy or irreparable cuff tears. PLoS One, 2017, 12(3): e0174361.
36.	Greiner SH, Back DA, Herrmann S, et al. Degenerative changes of the deltoid muscle have impact on clinical outcome after reversed total shoulder arthroplasty. Arch Orthop Trauma Surg, 2010, 130(2): 177-183.
37.	Schoch BS, Vigan M, Roche CP, et al. Deltoid fatigue: a longitudinal assessment of reverse shoulder arthroplasty over time. J Shoulder Elbow Surg, 2021, 30(6): 1375-1383.
38.	Pastor MF, Ferle M, Hagenah J, et al. The stabilization effect of the conjoint tendon in reverse total shoulder arthroplasty. Clin Biomech (Bristol, Avon), 2019, 63: 179-184.
39.	Mallett K, Nguyen NTV, Giambini H, et al. Changes in deltoid muscle tension after reverse shoulder arthroplasty as quantified by shear wave elastography: relationship with radiographic parameters and functional outcomes. Seminars in Arthroplasty: JSES, 2021, 31(4): 751-758.
40.	Jobin CM, Brown GD, Bahu MJ, et al. Reverse total shoulder arthroplasty for cuff tear arthropathy: the clinical effect of deltoid lengthening and center of rotation medialization. J Shoulder Elbow Surg, 2012, 21(10): 1269-1277.
41.	Kikukawa K, Ide J, Kikuchi K, et al. Hypertrophic changes of the teres minor muscle in rotator cuff tears: quantitative evaluation by magnetic resonance imaging. J Shoulder Elbow Surg, 2014, 23(12): 1800-1805.
42.	Hung LW, Wu S, Lee A, et al. Teres minor muscle hypertrophy is a negative predictor of outcomes after reverse total shoulder arthroplasty: an evaluation of preoperative magnetic resonance imaging and postoperative implant position. J Shoulder Elbow Surg, 2021, 30(10): e636-e645.
43.	Wiater BP, Koueiter DM, Maerz T, et al. Preoperative deltoid size and fatty infiltration of the deltoid and rotator cuff correlate to outcomes after reverse total shoulder arthroplasty. Clin Orthop Relat Res, 2015, 473(2): 663-673.
44.	Jang YH, Kim DO, Kim SH. Effect of preoperative teres minor hypertrophy on reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2020, 29(6): 1136-1144.
45.	Matthewson G, Kooner S, Kwapisz A, et al. The effect of subscapularis repair on dislocation rates in reverse shoulder arthroplasty: a meta-analysis and systematic review. J Shoulder Elbow Surg, 2019, 28(5): 989-997.
46.	Friedman RJ, Flurin PH, Wright TW, et al. Comparison of reverse total shoulder arthroplasty outcomes with and without subscapularis repair. J Shoulder Elbow Surg, 2017, 26(4): 662-668.
47.	Hartline JT, Brolin TJ, Wan JY, et al. The effect of subscapularis management technique on outcomes and complication rates following reverse total shoulder arthroplasty. Seminars in Arthroplasty: JSES, 2020, 30(1): 42-49.
48.	Franceschetti E, de Sanctis EG, Ranieri R, et al. The role of the subscapularis tendon in a lateralized reverse total shoulder arthroplasty: repair versus nonrepair. Int Orthop, 2019, 43(11): 2579-2586.
49.	Hung NJ, Wong SE. Gender influences on shoulder arthroplasty. Curr Rev Musculoskelet Med, 2022, 15(1): 21-26.
50.	Wong SE, Pitcher AA, Ding DY, et al. The effect of patient gender on outcomes after reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2017, 26(11): 1889-1896.
51.	Matsen FA, Li N, Gao H, et al. Factors affecting length of stay, readmission, and revision after shoulder arthroplasty: a population-based study. J Bone Joint Surg (Am), 2015, 97(15): 1255-1263.
52.	Aibinder W, Schoch B, Parsons M, et al. Risk factors for complications and revision surgery after anatomic and reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2021, 30(11): e689-e701.
53.	Ek ET, Neukom L, Catanzaro S, et al. Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years. J Shoulder Elbow Surg, 2013, 22(9): 1199-1208.
54.	Hartzler RU, Steen BM, Hussey MM, et al. Reverse shoulder arthroplasty for massive rotator cuff tear: risk factors for poor functional improvement. J Shoulder Elbow Surg, 2015, 24(11): 1698-1706.
55.	Morris BJ, O’Connor DP, Torres D, et al. Risk factors for periprosthetic infection after reverse shoulder arthroplasty. J Shoulder Elbow Surg, 2015, 24(2): 161-166.
56.	Matthews CJ, Wright TW, Farmer KW, et al. Outcomes of primary reverse total shoulder arthroplasty in patients younger than 65 years old. J Hand Surg (Am), 2019, 44(2): 104-111.
57.	De Martino I, Gulotta LV. The effect of obesity in shoulder arthroplasty outcomes and complications. Orthop Clin North Am, 2018, 49(3): 353-360.
58.	Surace P, Sultan AA, George J, et al. The association between operative time and short-term complications in total hip arthroplasty: an analysis of 89, 802 surgeries. J Arthroplasty, 2019, 34(3): 426-432.
59.	Wang Q, Goswami K, Shohat N, et al. Longer operative time results in a higher rate of subsequent periprosthetic joint infection in patients undergoing primary joint arthroplasty. J Arthroplasty, 2019, 34(5): 947-953.
60.	Eichinger JK, Rao MV, Lin JJ, et al. The effect of body mass index on internal rotation and function following anatomic and reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2021, 30(2): 265-272.
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1. Thon SG, Seidl AJ, Bravman JT, et al. Advances and update on reverse total shoulder arthroplasty. Curr Rev Musculoskelet Med, 2020, 13(1): 11-19.
2. Kozak T, Bauer S, Walch G, et al. An update on reverse total shoulder arthroplasty: current indications, new designs, same old problems. EFORT Open Rev, 2021, 6(3): 189-201.
3. Collin P, Hervé A, Walch G, et al. Mid-term results of reverse shoulder arthroplasty for glenohumeral osteoarthritis with posterior glenoid deficiency and humeral subluxation. J Shoulder Elbow Surg, 2019, 28(10): 2023-2030.
4. Viswanath A, Bale S, Trail I. Reverse total shoulder arthroplasty for irreparable rotator cuff tears without arthritis: A systematic review. J Clin Orthop Trauma, 2021, 17: 267-272.
5. Rugg CM, Coughlan MJ, Lansdown DA. Reverse total shoulder arthroplasty: biomechanics and indications. Curr Rev Musculoskelet Med, 2019, 12(4): 542-553.
6. Lee DH, Choi YS, Potter HG, et al. Reverse total shoulder arthroplasty: an imaging overview. Skeletal Radiol, 2020, 49(1): 19-30.
7. Molé D, Favard L. Excentered scapulohumeral osteoarthritis. Rev Chir Orthop Reparatrice Appar Mot, 2007, 93(6 Suppl): 37-94.
8. Gustas-French C, Petscavage-Thomas J, Bernard SA. Imaging of shoulder arthroplasties. AJR Am J Roentgenol, 2018, 211(3): 485-495.
9. Molé D, Wein F, Dézaly C, et al. Surgical technique: the anterosuperior approach for reverse shoulder arthroplasty. Clin Orthop Relat Res, 2011, 469(9): 2461-2468.
10. Boileau P. Complications and revision of reverse total shoulder arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S33-S43.
11. Jang YH, Lee JH, Kim SH. Effect of scapular notching on clinical outcomes after reverse total shoulder arthroplasty. Bone Joint J, 2020, 102-B(11): 1438-1445.
12. Kempton LB, Balasubramaniam M, Ankerson E, et al. A radiographic analysis of the effects of glenosphere position on scapular notching following reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2011, 20(6): 968-974.
13. Kelly JD, Humphrey CS, Norris TR. Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part One: The twelve-mm rule. J Shoulder Elbow Surg, 2008, 17(4): 589-594.
14. Kontaxis A, Johnson GR. The biomechanics of reverse anatomy shoulder replacement—a modelling study. Clin Biomech (Bristol, Avon), 2009, 24(3): 254-260.
15. Nyffeler RW, Werner CM, Gerber C. Biomechanical relevance of glenoid component positioning in the reverse Delta Ⅲ total shoulder prosthesis. J Shoulder Elbow Surg, 2005, 14(5): 524-528.
16. Lawrence C, Williams GR, Namdari S. Influence of glenosphere design on outcomes and complications of reverse arthroplasty: A systematic review. Clin Orthop Surg, 2016, 8(3): 288-297.
17. 柳金浪, 段志豪, 周游. 反式全肩关节置换的研究进展. 中国矫形外科杂志, 2021, 29(22): 2063-2066.
18. Frank JK, Siegert P, Plachel F, et al. The evolution of reverse total shoulder arthroplasty-from the first steps to novel implant designs and surgical techniques. J Clin Med, 2022, 11(6): 1512.
19. Pilliar RM, Lee JM, Maniatopoulos C. Observations on the effect of movement on bone ingrowth into porous-surfaced implants. Clin Orthop Relat Res, 1986, (208): 108-113.
20. Zhang M, Junaid S, Gregory T, et al. Effect of baseplate positioning on fixation of reverse total shoulder arthroplasty. Clin Biomech (Bristol, Avon), 2019, 62: 15-22.
21. Fávaro RC, Abdulahad M, Filho SM, et al. Rotator cuff arthropathy: what functional results can be expected from reverse arthroplasty? Rev Bras Ortop, 2015, 50(5): 523-529.
22. Farshad M, Gerber C. Reverse total shoulder arthroplasty-from the most to the least common complication. Int Orthop, 2010, 34(8): 1075-1082.
23. Franceschi F, Giovannetti de Sanctis E, Gupta A, et al. Reverse shoulder arthroplasty: State-of-the-art. J ISAKOS, 2023, 8(5): 306-317.
24. 韩晓珺, 戚文潇, 方朝毅, 等. 反置式全肩关节置换术治疗巨大不可修复性肩袖损伤研究进展. 国际骨科学杂志, 2017, 38(6): 341-344.
25. Weston M, Gandhi MJ, Henning S, et al. Reverse shoulder arthroplasty for non-traumatic problems. Orthopaedics and Trauma, 2018, 32(3): 178-185.
26. Gulotta LV, Choi D, Marinello P, et al. Humeral component retroversion in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elbow Surg, 2012, 21(9): 1121-1127.
27. Henninger HB, Barg A, Anderson AE, et al. Effect of deltoid tension and humeral version in reverse total shoulder arthroplasty: a biomechanical study. J Shoulder Elbow Surg, 2012, 21(4): 483-490.
28. Virani NA, Cabezas A, Gutiérrez S, et al. Reverse shoulder arthroplasty components and surgical techniques that restore glenohumeral motion. J Shoulder Elbow Surg, 2013, 22(2): 179-187.
29. Gutiérrez S, Comiskey CA, Luo ZP, et al. Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors. J Bone Joint Surg (Am), 2008, 90(12): 2606-2615.
30. Erickson BJ, Frank RM, Harris JD, et al. The influence of humeral head inclination in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg, 2015, 24(6): 988-993.
31. Constant CR, Gerber C, Emery RJ, et al. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg, 2008, 17(2): 355-361.
32. Rhee YG, Cho NS, Moon SC. Effects of humeral component retroversion on functional outcomes in reverse total shoulder arthroplasty for cuff tear arthropathy. J Shoulder Elbow Surg, 2015, 24(10): 1574-1581.
33. Stephenson DR, Oh JH, McGarry MH, et al. Effect of humeral component version on impingement in reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2011, 20(4): 652-658.
34. Berhouet J, Garaud P, Favard L. Influence of glenoid component design and humeral component retroversion on internal and external rotation in reverse shoulder arthroplasty: a cadaver study. Orthop Traumatol Surg Res, 2013, 99(8): 887-894.
35. Yoon JP, Seo A, Kim JJ, et al. Deltoid muscle volume affects clinical outcome of reverse total shoulder arthroplasty in patients with cuff tear arthropathy or irreparable cuff tears. PLoS One, 2017, 12(3): e0174361.
36. Greiner SH, Back DA, Herrmann S, et al. Degenerative changes of the deltoid muscle have impact on clinical outcome after reversed total shoulder arthroplasty. Arch Orthop Trauma Surg, 2010, 130(2): 177-183.
37. Schoch BS, Vigan M, Roche CP, et al. Deltoid fatigue: a longitudinal assessment of reverse shoulder arthroplasty over time. J Shoulder Elbow Surg, 2021, 30(6): 1375-1383.
38. Pastor MF, Ferle M, Hagenah J, et al. The stabilization effect of the conjoint tendon in reverse total shoulder arthroplasty. Clin Biomech (Bristol, Avon), 2019, 63: 179-184.
39. Mallett K, Nguyen NTV, Giambini H, et al. Changes in deltoid muscle tension after reverse shoulder arthroplasty as quantified by shear wave elastography: relationship with radiographic parameters and functional outcomes. Seminars in Arthroplasty: JSES, 2021, 31(4): 751-758.
40. Jobin CM, Brown GD, Bahu MJ, et al. Reverse total shoulder arthroplasty for cuff tear arthropathy: the clinical effect of deltoid lengthening and center of rotation medialization. J Shoulder Elbow Surg, 2012, 21(10): 1269-1277.
41. Kikukawa K, Ide J, Kikuchi K, et al. Hypertrophic changes of the teres minor muscle in rotator cuff tears: quantitative evaluation by magnetic resonance imaging. J Shoulder Elbow Surg, 2014, 23(12): 1800-1805.
42. Hung LW, Wu S, Lee A, et al. Teres minor muscle hypertrophy is a negative predictor of outcomes after reverse total shoulder arthroplasty: an evaluation of preoperative magnetic resonance imaging and postoperative implant position. J Shoulder Elbow Surg, 2021, 30(10): e636-e645.
43. Wiater BP, Koueiter DM, Maerz T, et al. Preoperative deltoid size and fatty infiltration of the deltoid and rotator cuff correlate to outcomes after reverse total shoulder arthroplasty. Clin Orthop Relat Res, 2015, 473(2): 663-673.
44. Jang YH, Kim DO, Kim SH. Effect of preoperative teres minor hypertrophy on reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2020, 29(6): 1136-1144.
45. Matthewson G, Kooner S, Kwapisz A, et al. The effect of subscapularis repair on dislocation rates in reverse shoulder arthroplasty: a meta-analysis and systematic review. J Shoulder Elbow Surg, 2019, 28(5): 989-997.
46. Friedman RJ, Flurin PH, Wright TW, et al. Comparison of reverse total shoulder arthroplasty outcomes with and without subscapularis repair. J Shoulder Elbow Surg, 2017, 26(4): 662-668.
47. Hartline JT, Brolin TJ, Wan JY, et al. The effect of subscapularis management technique on outcomes and complication rates following reverse total shoulder arthroplasty. Seminars in Arthroplasty: JSES, 2020, 30(1): 42-49.
48. Franceschetti E, de Sanctis EG, Ranieri R, et al. The role of the subscapularis tendon in a lateralized reverse total shoulder arthroplasty: repair versus nonrepair. Int Orthop, 2019, 43(11): 2579-2586.
49. Hung NJ, Wong SE. Gender influences on shoulder arthroplasty. Curr Rev Musculoskelet Med, 2022, 15(1): 21-26.
50. Wong SE, Pitcher AA, Ding DY, et al. The effect of patient gender on outcomes after reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2017, 26(11): 1889-1896.
51. Matsen FA, Li N, Gao H, et al. Factors affecting length of stay, readmission, and revision after shoulder arthroplasty: a population-based study. J Bone Joint Surg (Am), 2015, 97(15): 1255-1263.
52. Aibinder W, Schoch B, Parsons M, et al. Risk factors for complications and revision surgery after anatomic and reverse total shoulder arthroplasty. J Shoulder Elbow Surg, 2021, 30(11): e689-e701.
53. Ek ET, Neukom L, Catanzaro S, et al. Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years. J Shoulder Elbow Surg, 2013, 22(9): 1199-1208.
54. Hartzler RU, Steen BM, Hussey MM, et al. Reverse shoulder arthroplasty for massive rotator cuff tear: risk factors for poor functional improvement. J Shoulder Elbow Surg, 2015, 24(11): 1698-1706.
55. Morris BJ, O’Connor DP, Torres D, et al. Risk factors for periprosthetic infection after reverse shoulder arthroplasty. J Shoulder Elbow Surg, 2015, 24(2): 161-166.
56. Matthews CJ, Wright TW, Farmer KW, et al. Outcomes of primary reverse total shoulder arthroplasty in patients younger than 65 years old. J Hand Surg (Am), 2019, 44(2): 104-111.
57. De Martino I, Gulotta LV. The effect of obesity in shoulder arthroplasty outcomes and complications. Orthop Clin North Am, 2018, 49(3): 353-360.
58. Surace P, Sultan AA, George J, et al. The association between operative time and short-term complications in total hip arthroplasty: an analysis of 89, 802 surgeries. J Arthroplasty, 2019, 34(3): 426-432.
59. Wang Q, Goswami K, Shohat N, et al. Longer operative time results in a higher rate of subsequent periprosthetic joint infection in patients undergoing primary joint arthroplasty. J Arthroplasty, 2019, 34(5): 947-953.
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Chinese Journal of Reparative and Reconstructive Surgery

Influencing factors on effectiveness of reverse total shoulder arthroplasty

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