Short-term results of the reverse Total Evolutive Shoulder System (TESS) in cuff tear XXXX and revision arthroplasty cases.

@entity1 @entity86 @entity2720
INTRODUCTION: The aim of this study was to evaluate the clinical and radiological outcome of the Total Evolutive Shoulder System (TESS) in @entity1 with cuff tear @entity2720 and @entity1 in need of a revision arthroplasty. METHODS: In this sequential study, 67 @entity1 (56 non-stemmed, 11 stemmed) were evaluated after a mean follow-up of 17.5  months. The relative Constant and DASH scores, radiological joint geometry changes, complications and @entity86 , which are not likely to affect the outcome, were evaluated. RESULTS: A significant increase was noticed for the relative Constant (11.3 vs. 78.8  %) and DASH scores (73.7 vs. 31.8) without significant differences between both etiology groups. Complication rates were similar to previous studies. An aseptic loosening of the non-stemmed humeral component was not noticed in the cuff tear @entity2720 group, whereas one case with a loosening was noticed in the revision arthroplasty group. With nine cases (13.4  %), scapular notching rates were very low. On average, the acromiohumeral distance increased by 17  mm and the humeral offset by 13.9  mm; the height of the center of rotation decreased by 4.6  mm and the lateral glenohumeral offset by 6.1  mm, p  <  0.05, respectively. CONCLUSION: Regarding the joint geometry, surgery with the TESS system provided adequate distalization and medialization of the humerus and the center of rotation. This corresponds to a good clinical outcome. The use of the surgical opportunity to implant the prosthesis with a relatively low neck-shaft angle might explain the low rates of scapular notching in our series. Regarding the case with a loosening of the humeral component, the surgeon should carefully indicate a stemless version for metaphyseal press-fit fixation in @entity1 with revision arthroplasty.
