Reverse Total Shoulder Replacement – Long Term Follow Up with the Constant Score

Completed Research - Long Term Projects

Reverse Total Shoulder Replacement – Long Term Follow Up with the Constant Score

Background

Reverse total shoulder replacement* has grown in popularity over the past decade. The technique is used when conventional shoulder replacement fails. It is also used for rheumatoid arthritis patients with irreparable cuff tears and patients with proximal humeral tumours.

The complication rate for the procedure, however, continues to be high. Implants have limited longevity and there is a lack of long term functional outcome data, all of which feed concerns regarding its continued widespread use. With this study, we wish to see how outcomes vary both in the short and long term and improve upon the paucity of long term data both locally and globally.

The Constant Score^ is a widely used shoulder-specific scoring system. Devised by Christopher Constant in 1987, this functional assessment score was conceived as a system of assessing the overall value, or functional state, of a normal, diseased or treated shoulder. In 1992, the European Shoulder and Elbow Society mandated the use of the Constant Score in all peer-reviewed papers, making it the most widely used shoulder evaluation instrument in Europe (and around the world). It is reliable and reproducible, providing a subjective and objective measure of patient symptoms and strength. It also provides an important measure for patient follow up and has the potential to highlight specific patient concerns.

Objectives

The objective of this study is to evaluate the long term subjective and objective outcomes in patients undergoing reverse total shoulder replacement using the Constant Score.

Design

This is a prospective observational study.

Study Procedure

All participants meeting inclusion criteria will be administered the Constant Score pre-operatively and then post-operatively each year from 1 to 10 years.

Inclusion Criteria

Patients undergoing reverse total shoulder replacement surgery
Willingness to give written informed consent and willingness to participate in and comply with the Study

Exclusion Criteria

Patients undergoing reverse total shoulder replacement surgery as a result of trauma eg fracture

Status

Participants are at various stages of data collection. Earliest recruits have reached the 5 year post-operative follow up mark.

References

Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987 Jan;(214)(214):160-164.
Johansson KM, Adolfsson LE. Intraobserver and interobserver reliability for the strength test in the Constant-Murley shoulder assessment. J Shoulder Elbow Surg 2005 May-Jun;14(3):273-278.
Kuhlman JR, Iannotti JP, Kelly MJ, Riegler FX, Gevaert ML, Ergin TM. Isokinetic and isometric measurement of strength of external rotation and abduction of the shoulder. J Bone Joint Surg Am 1992 Oct;74(9):1320-1333.
Levy O, Haddo O, Massoud S, Mullett H, Atoun E. A patient-derived Constant-Murley score is comparable to a clinician-derived score. Clin Orthop Relat Res 2014 Jan;472(1):294-303.
Moseley HF. Examination of the shoulder. Shoulder lesions. 3rd ed. Edinburgh: Churchill Livingstone; 1969. p. 20-30.
Nam D, Kepler CK, Neviaser AS, Jones KJ, Wright TM, Craig EV and Warren RF. Reverse Total Shoulder Arthroplasty: Current Concepts, Results and Component Wear Analysis. J Bone Joint Surg Am. 2010;92:23035.
Cazeneuve JF and Cristofari DJ. Long term functional outcome following reverse shoulder arthroplasty in the elderly. Orthopaedics & Traumatology: Surgery & Research (2011);97:583-589.

* Learn more about Reverse Total Shoulder Replacement

^ Learn more about the Constant Score

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