The Delta III reverse shoulder replacement for cuff tear XXXX : a single-centre study of 50 consecutive procedures.

@entity2720 @entity1 @entity625 @entity158
The combination of an irreparable tear of the rotator cuff and @entity625 joint may cause severe @entity158 , disability and loss of independence in the aged. Standard anatomical shoulder replacements depend on a functioning rotator cuff, and hence may fail in the presence of tears in the cuff. Many designs of non-anatomical constrained or semi-constrained prostheses have been developed for cuff tear @entity2720 , but have proved unsatisfactory and were abandoned. The DePuy Delta III reverse prosthesis, designed by Grammont, medialises and stabilises the centre of rotation of the shoulder joint and has shown early promise. This study evaluated the mid-term clinical and radiological results of this arthroplasty in a consecutive series of 50 shoulders in 43 @entity1 with a @entity158 due to an irreparable cuff tear and @entity625 , performed over a period of seven years by a single surgeon. A follow-up of 98% was achieved, with a mean duration of 39 months (8 to 81). The mean age of the @entity1 at the time of surgery was 81 years (59 to 95). The female to male ratio was 5:1. During the seven years, six @entity1 died of natural causes. The clinical outcome was assessed using the American Shoulder and Elbow score, the Oxford Shoulder Score and the Short-form 36 score. A radiological review was performed using the Sirveaux score for scapular notching. The mean American Shoulder and Elbow score was 19 (95% confidence interval (CI) 14 to 23) pre-operatively, and 65 (95% CI 48 to 82) (paired t-test, p < 0.001) at final follow-up. The mean Oxford score was 44 (95% CI 40 to 51) pre-operatively and 23 (95% CI 18 to 28) (paired t-test, p < 0.001) at final follow-up. The mean maximum elevation improved from 55   pre-operatively to 105   at final follow-up. There were seven complications during the whole series, although only four @entity1 required further surgery.
