ln common practise, reversed shoulder prosthesis is implanted in patients with rotator cuff tendon deficient arthritic shoulder (RCDA). A lot of studies have in fact showed excel- lent results with regard to pain reduction and improvement of active ROM. A recent mul- ticentric study, performed on 98 patients with cuff tear arthropathy who underwent Delta prosthesis, has showed that at follow up (4 yrs), all parameters considered in Constant\rdblquote s shoulder evaluation form were increased. The pre and post\emdash op Constant score was, respec- tively, 23.9 and 62.7. However, internal and external rotation increased only of 1 and 4.3 points, respectively and about lO% of patients sustained a complication (intolerance to prosthesis material, superficial infections, mobilisation of glenosphere, prosthesis disloca- l tion, mobilisation of metaglene, resorption of the medial cortex). These complications do not include the scapular notches that, however, are not always responsible for pain. l Even if traditionally reversed shoulder prosthesis is implanted in patients with RCDA, i it may be utilised in very elderly patients with massive and irreparable cuff tear without 4 degenerative changes of gleno\emdash humeral joint. ln fact time of immobilisation and of reha- I bilitation after prosthesis implant is less than that requested after muscle transfer. In conclusion, it seems that the reversed shoulder prosthesis does have potential bene- ] fits with good results shown for the early and mid range follow up periods, especially in terms of mobility and pain and when rotator cuff arthropathy patients are separated from I those with other RCDA. However, larger patients number published studies are needed to substantiate these benefits and longer follow up period is necessary to evaluate the per- I centage, progressivcness and significance of glenoid loosening and glenoid notching.
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