Clinical Efficacy of Reverse Total Shoulder Arthroplasty with Humeral Prosthesis of Different Retroversion Angles for the Treatment of Irreparable Massive Rotator Cuff Tears

Ruan Weitao; Yu Yanling; Wang Changbing; Li Yanjin; Zhao Lilian

doi:10.3969/j.issn.1008-5572.2026.01.003

Abstract：Objective To investigate the short to medium-term clinical efficacy of reverse total shoulder arthroplasty with humeral prosthesis implanted at 30 ° and 0 ° retroversion angles for the treatment of irreparable massive rotator cuff tears.Methods A retrospective analysis was conducted on the data of 25 patients with irreparable massive rotator cuff tears who underwent reverse total shoulder arthroplasty in Foshan traditional Chinese medicine hospital from January 2016 to September 2022.They were divided into two groups according to the retroversion angle of the humeral prosthesis.There were 17 cases in the 30 ° humeral prosthesis retroversion angle group,including 5 males and 12 females,aged 58～81 years with an average age of(69.35±5.31)years.There were 8 cases in the 0 ° humeral prosthesis retroversion angle group,including 3 males and 5 females,aged 58～81 years with an average age of(64.63±6.28)years.The postoperative American shoulder and elbow surgeons(ASES)score,Constant-Murley score,visual analogue scale(VAS),University of California Los Angeles(UCLA)shoulder score,shoulder range of motion,and postoperative complications were compared between the two groups.Results 25 patients were included with mean followed up of(39.68±17.90)months(26.00～90.95 months).Both groups showed improvements in postoperative ASES scores,Constant scores,UCLA scores,VAS scores,as well as forward flexion,external rotation,and internal rotation.There was a statistically significant difference in external rotation angle between the two groups(P＜0.05),with the 30 retroversion angle group at(41.18±9.61)°and the 0 ° retroversion angle group at(30.63±15.68)°.No statistically significant differences were observed in the remaining indicators(P＞0.05).One case of scapular notching was observed in the 0 °retroversion angle group and one case of acromial fracture was observed in the 30 °retroversion angle group respectively.Conclusion Reverse total shoulder arthroplasty has a good clinical effect in the treatment of irreparable massive rotator cuff tears.Implantation of the humeral prosthesis at a 30 ° retroversion angle is more conducive to improving the postoperative shoulder external rotation angle.