Effective Survey Of Reversed Total Shoulder Prosthesis For Massive And Irreparable Rotator Cuff Tears / Cuff Tear Arthropathy

Objectives:1. To introduce three different reversed total shoulder prosthesis—Grammont prosthesis(Delta III),RSP(ENCORE)and SMR;2. To analyse the effect of those prosthesis when implanted for massive and irreparable rotator cuff tears /cuff tear arthropathy(CTA);3. To guide the best choice for domestic clinical practice.Methods:1. To search for related articles:①eligibility criteria: the patients treated by implanting reversed shoulder prosthesis for massive cuff tears or CTA; cases including outcomes and scores preoperatively or/and postoperatively; full articles.②exlcusion criteria:patients not treated by RSA; RSA for fracture sequelae or shoulder revision, not mainly for massive and irreparable rotator cuff tears/CTA; repeated articles; not English or French articles.2. To clarify data into different categories: comparison of all the studies about Delta III; comparison of the studies among Delta III,RSP and SMR prosthesis.Results:1. Obviously, Delta III prosthesis could eliminate pain and improve ROM postoperatively, and mean follow-up in the studies between 17 and 72 months with a greatly maximum satisfaction rate of 96%. However it has a high rate of reoperation which could reach to 39%.2. Effectively, all the implants Delta III,RSP and SMR have the functions of pain relief and ROM restoration. Delta III prosthesis has a widely clinical use and more data for mid-term and long-term study. RSP prosthesis has the most evident improvement on external rotation(to 36°), but still has a high postoperative reoperation rate. SMR implant seems to have no reoperation rate at a mean follow-up of 38 months, but it requires the experienced surgeons and has limitations of long-term outcomes.Conclusions:1. Reversed total shoulder prosthesis has provided a completely new and effective method for massive and ireparable rotator cuff tears/ CTA after implanted, and probably, it will have an advanced development in clinical settings.2. Related complications for reversed shoulder prosthesis could be globally assessed by further biomechanical study and clinical outcomes, and that could probably provide new theories for novel implants. 3. Different factors such as patients, surgeons and medical environment should be seriously concerned for domestic clinal use, the best implant for greatest benifits and postoperative satisfaction are immensely important.