Article

We hypothesize that performing a RSA using an anterior approach
without cutting the subscapularis tendon and the deltoid muscle could provide
patients with superior short-term clinical outcomes and immediate active range of
motion (ROM) without immobilization. METHODS: Between August 2013 and June 2015,
all patients who had a primary RSA were considered potentially eligible for
inclusion in this prospective study. RESULTS:
No immediate intra- or
postoperative complications were noted. A statistically significant improvement
of VAS (from 6.7 to 1; P<.001), SANE (from 34 to 80; P<.001), and elevation (from
103 degrees to 128 degrees ; P=.02) was observed. In some cases, patients who had
pseudoparalysis preoperative were able to achieve full anterior elevation few
days after the operation. DISCUSSION: Using a subscapularis and deltoid
preserving anterior approach is an option for patients requiring RSA. Leaving
this tendon intact and preserving the deltoid minimize the need for immediate
postoperative immobilization and allow for faster recovery of shoulder ROM,
without risking the concern of humeral anterior dislocation. Overall duration of
hospital stay as well as length of postoperative physical therapy may be
minimized, with substantial long-term economic gain. Longer follow-up and
comparison with standard approaches is necessary in the future. LEVEL OF EVIDENCE: Level IV, case series with no comparative group.
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Langue : FRANCAIS