UNIVERS 3-D肩关节假体置换治疗盂肱关节不稳性骨关节炎

目的评价UNIVERS3-D肩关节假体置换治疗盂肱关节不稳性骨关节炎的临床效果。方法采用UNIVERS3-D肩关节假体置换治疗16例盂肱关节不稳性骨关节炎,平均随访30.8个月(12～50个月),术前、术后12个月及最后随访均进行功能评估和摄X线片。功能评估采用Constant评分和Constant修正评分;评分内容包括:疼痛、日常生活、活动范围和肌力评分;根据性别及随访时的年龄进行功能修正评分。采用t检验对术前、术后12个月及最后随访的Constant评分和Constant修正评分进行统计学分析。X线片包括:前后位、轴位和“Y”型位。结果术前盂肱关节不稳性骨关节炎肱骨头、盂唇下缘外生骨赘轻度占72.7%(8/11)。Constant功能评分从术前(43.8±13)分(修正评分51.36%±15.40%)提高到(70.6±17.69)分(修正评分86.44%±22.12%)。疼痛、日常生活、活动范围和肌力评分术后均较术前有明显的提高。肱骨假体无松动、下沉和倾斜,盂假体无松动、位移和倾斜。无肱骨假体头-颈连接部的松动和脱位。1例出现肱骨假体周围X线透亮带,透亮带系数小于1,即没有松动。2例发生并发症,1例由骨赘引起假体间撞击征,1例聚乙烯衬垫松动。结论UNIVERS3-D肩关节假体置换治疗盂肱关节不稳性骨关节炎术后较术前功能有明显的提高,X线透亮带发生率及并发症发生率低。     

反式全肩关节假体置换治疗巨大不可修复肩袖撕裂

目的探讨反式全肩关节置换术（reverse total shoulder arthroplasty,RTSA）治疗巨大不可修复肩袖撕裂的临床治疗效果。 方法对南京中医药大学附属医院2018年5月至2020年1月收治的采取RTSA治疗的13例巨大不可修复肩袖撕裂患者的临床资料进行回顾性分析。记录术前及最后一次随访时患者的肩关节前屈、外展、外旋活动,美国肩肘外科协会评分（American shoulder and elbow surgeons score,ASES）及美国加州大学洛杉矶分校（University of California at Los Angeles,UCLA）评分评估患者肩关节功能。并记录患者发生并发症的情况及影像学检查结果。术前行MR确定肩袖脂肪浸润程度,CT评价肩胛盂骨质情况及有无缺损,术后使用X线评估假体情况。 结果13例患者均随访至少12个月以上。统计术前与术后12个月数据之间的关系,术后12个月肩关节前屈、外展、外旋活动,ASES评分和UCLA评分较术前明显提高,差异具有统计学意义（P<0.01）。随访期内13例患者中有1例患者因局部血肿在术后1周行切开血肿清除引流术,所有患者功能恢复良好。 结论RTSA治疗巨大不可修复肩袖撕裂临床效果良好。     

关节镜下肩袖缝合术治疗肩袖撕裂

目的探讨关节镜下肩袖缝合术治疗肩袖撕裂的手术方法和临床效果。方法2002年12月至2005年10月，对27例肩袖撕裂患者行关节镜下肩袖缝合术，25例获得1年以上随访，其中男12例，女13例；年龄35～67岁，平均54．3岁；左肩6例，右肩19例，涉及优势侧19例。10例滑囊侧部分撕裂，1例滑囊侧及关节侧均有部分撕裂，14例全层撕裂。术前均拍摄肩关节正位和冈上肌出口位X线片，21例行B超检查，23例行MR或MRA检查。全部病例行肩峰下滑囊切除及前肩峰成形术。肩袖修复方式：1例直接行断端缝合，15例应用缝合锚钉行肩袖止点重建，9例联合应用断端缝合及缝合锚钉技术。分别在术前和最终随访时采用UCLA肩关节评分标准进行评价。结果随访时间1～3年，平均23个月。术后平均UCLA评分为（32．3±t2．3）分。手术前后疼痛评分平均为（2．6±t0．9）分和（8．6±1．4）分（P=0．000），功能评分平均为（5．0±1．8）分和（9．1±1．0）分（P=0．000），肩关节主动前屈评分平均为（3．6±1.5）分和（4．9±10.3）分（P=0．000），前屈肌力评分平均为（4．0±0．6）分和（4．7±0．5）分（P=0．000），差异均有统计学意义。优8例、良17例，所有患者均对手术效果表示满意。结论关节镜下肩袖缝合术是治疗肩袖撕裂的有效方法。术中应有效地控制出血，适度进行肩峰成形，正确识别撕裂的形状，充分松解粘连并采用恰当的缝合方式。手术创伤小、恢复快，其疗效可达到切开手术水平。     

关节镜下肩袖缝合术治疗肩袖全层撕裂的中期疗效观察

目的 探讨关节镜下肩袖缝合术治疗肩袖全层撕裂的手术方法和中期效果.方法 2002年12月至2007年5月对35例肩袖全层撕裂患者行关节镜下肩袖缝合术,30例获得随访,其中男性15例,女性15例;年龄31～74岁,平均55.6岁.左肩3例,右肩27例.全部病例行肩峰下滑囊切除及肩峰成形术.肩袖修复方式:19例应用缝合锚钉行肩袖止点重建,11例联合应用断端缝合及缝合锚钉技术.16例行单排缝合,14例行双排缝合.2012年6月对所有患者进行随访,分别在术前和随访时采用UCLA肩关节评分标准进行评价,评分结果行配对t检验.结果 小型撕裂3例,中型撕裂22例,大型撕裂3例,巨大撕裂2例,随访时间5 ～ 10年,平均78.5个月.UCLA评分从术前的(14.2±3.1)分增至术后(33.6±2.1)分(t=-37.154,P=0.000).其中疼痛评分平均为(2.5±0.9)分比(9.5±1.0)分(t=-24.466,P=0.000),功能评分平均为(4.5±1.5)分比(9.4±1.1)分(t=-18.500,P=0.000),主动前屈角度评分平均为(3.3±1.6)分比(4.9±0.2)分(t=-5.614,P=0.000),前屈肌力评分平均为(3.9±0.5)分比(4.7±0.4)分(t=-6.591,P=0.000),差异均有统计学意义.根据术后随访UCLA评分,优19例,良11例.单排缝合患者术前平均(13.0±3.2)分,术后平均(33.6±1.7)分.双排缝合患者术前平均(15.6±2.4)分,术后平均(33.6±2.6)分,两组患者手术前后评分差异均有统计学意义(t=-33.071和-26.455,P＜0.05).所有患者对手术效果表示满意.结论 关节镜下肩袖缝合治疗肩袖全层撕裂创伤小、恢复快,中期效果令人满意.单排缝合与双排缝合的效果均令人满意.术中应正确识别撕裂的形状,充分松解粘连并采用恰当的缝合方式.     

肩袖缝合同期关节镜下360°松解治疗肩袖损伤合并全方位肩关节粘连

目的 :评估肩袖损伤合并全方位肩关节粘连患者,进行肩袖缝合同期关节镜下360°关节囊松解手术的临床疗效。方法:2016年12月至2018年12月共收治247例肩袖全层撕裂的患者,采用关节镜下肩袖缝合手术治疗。其中全方位肩关节活动受限的患者42例(17%),在肩袖缝合的同时,采取关节镜下360°关节囊松解手术。分别在术前及末次随访时采用Constant-Murley评分,疼痛视觉模拟评分(visual analogue score,VAS),前屈、外展及体侧外旋角度进行肩关节功能评估。采用核磁影像Sugaya分类对肩袖愈合情况进行评估。记录随访过程中肩脱位发生的次数。结果:42例中39例获得随访,随访时间12～36(22±6)个月。患者手术时年龄43～73(57±7)岁,Constant-Murley评分自术前的(43.6±6.3)分提升至末次随访的(87.5±2.8)分(P<0.001)。VAS评分自术前的(7.2±1.5)分降低至末次随访的(1.0±0.9)分(P<0.001)。肩关节前屈自术前的(46±14)°提高至术后的(148±11)°(P<0.001),外展...     

关节镜下缝线桥技术治疗巨大肩袖撕裂的临床研究

目的探讨关节镜下缝线桥技术缝合巨大肩袖撕裂的临床疗效。 方法回顾分析2014年6月至2016年6月在广州市正骨医院收治并取得完整随访的38例采用关节镜下缝线桥技术修复的巨大肩袖撕裂患者的临床资料,排除无法取得随访、依从性差的患者,分析术前X线片、MRI检查,了解肩袖撕裂口大小、肩袖回缩程度、肌肉萎缩及脂肪浸润情况,应用SPSS 17.0统计学软件配对t检验对术前与术后半年随访时视觉模拟评分系统(VAS)评分和美国加州大学肩关节评分系统(UCLA)评分进行比较。 结果本组患者38例,男23例,女15例,平均年龄(66±6)岁,所有患者均获半年以上的随访,随访时间(12±5)月。所有患者在关节镜下均发现有2条或以上的肌腱撕裂,关节镜下见15例患者冈上肌腱和冈下肌腱撕裂,8例冈上肌、冈下肌和小圆肌腱撕裂,10例冈上肌腱、冈下肌腱撕裂和肩胛下肌腱撕裂,5例冈上肌腱和肩胛下肌腱撕裂。术前VAS评分为(6.7±1.6)分,术后6月随访时为(2.4±1.7)分,术前与术后6月随访的VAS评分差异均有统计学意义(t ＝10.123,P<0.01);术前UCLA评分为(7.9±1.2)分,术后6月随访时为(23.4±5.1)分,术前与术后6月随访的UCLA评分差异均有统计学意义(t ＝－18.979,P<0.01);术后的UCLA、VAS评分均明显升高。术后半年MR检查结果,5例患者出现小型再撕裂,裂口均<3 cm,术后再撕裂患者与无再撕裂患者的VAS评分和UCLA肩关节评分无明显统计学差异(P>0.05)。 结论关节镜下缝线桥技术修复巨大肩袖撕裂取得较好的短期疗效,是1种合理、有效的治疗方法。     

肩袖滑囊侧部分撕裂的诊断

目的 探讨肩袖滑囊侧部分撕裂的临床特点和诊断方法.方法 1999年8月至2006年6月,对38例肩袖滑囊侧部分撕裂患者进行手术治疗.男28例,女10例;年龄18～69岁,平均45.7岁.左肩11例,右肩27例.肩袖撕裂程度根据Ellman分类标准,Ⅰ度6例,Ⅱ度7例,Ⅲ度25例.术前对双侧肩关节进行系统检查.38例患者术前均拍摄肩关节正位和冈上肌出口位X线片,27例行B超检查,35例行MR或MRA检查.13例行肩峰下间隙减压及肩袖清理术,25例行肩峰下间隙减压及肩袖修复术.结果 38例患者均有肩部疼痛,夜间痛18例.夜间痛在Ⅰ、Ⅱ度与Ⅲ度撕裂患者间阳性率差异无统计学意义(P=0.095).25例患者肩关节前屈及外展肌力下降.物理检查中阳性率较高的包括:Neer撞击征92.1%(35/38),Hawkins撞击征71.1%(27/38),肱骨大结节压痛89.5%(34/38),60°～120°痛弧征68.4%(26/38),牵拉抗阻试验68.4%(26/38).根据Bigliani肩峰分型标准:Ⅰ型2例,Ⅱ型26例,Ⅲ型10例.B超检查的阳性检出率为48.1%(13/27),MR检查的阳性检出率为74.3%(26/35).结论 肩袖滑囊侧部分撕裂患者中,Neer撞击征及大结节压痛阳性率很高.B超和MR检查诊断肩袖滑囊侧部分撕裂有一定价值.关节镜检查仍然是诊断肩袖滑囊侧部分撕裂的最可靠方法.     

肩袖滑囊侧部分撕裂的关节镜手术治疗

目的 探讨关节镜治疗肩袖滑囊侧部分撕裂的手术方法 和临床效果.方法 对2002年6月至2007年12月行关节镜手术的57例肩袖滑囊侧部分撕裂患者进行回顾性分析.男性34例,女性15例,年龄25～71岁,平均年龄49.7岁.左肩15例,右肩34例,涉及优势侧41例.根据Ellman分类标准,Ⅰ度7例,Ⅱ度6例,Ⅲ度36例.术前均拍摄肩关节正位和冈上肌出口位X线片,29例行B超检查,36例行MRI或磁共振血管造影检查.Ⅰ度及Ⅱ度患者行肩峰下间隙减压及肩袖清理术;Ⅲ度患者行肩峰下间隙减压及肩袖修复术.肩袖修复方式:3例直接行断端缝合,26例应用缝合锚钉行肩袖止点重建,7例联合应用断端缝合及缝合锚钉技术.分别在术前和最终随访时采用UCLA肩关节评分标准进行评价.手术前UCLA评分平均为(16.5±2.4)分.其中疼痛评分平均为(2.9±1.0)分,功能评分平均为(5.4±1.2)分,肩关节主动前屈评分平均为(4.3±1.1)分,前屈肌力评分平均为(4.0±0.4)分.结果 49例患者均获得随访,随访时间2～7年,平均48个月.手术后平均UCLA评分为(32.1±3.8)分.其中疼痛评分平均为(8.4±1.7)分,功能评分平均为(9.1±1.4)分,肩关节主动前屈评分平均(4.9±0.2)分,前屈肌力评分平均为(4.8±0.4),与术前比较差异均具有统计学意义(均为P=0.000).优16例,良31例,差2例.47例患者对手术效果表示满意.结论 关节镜手术是治疗肩袖滑囊侧部分撕裂的有效方法 .手术创伤小、恢复快.     

肩袖损伤的关节镜下治疗

目的探讨肩关节镜手术治疗肩袖损伤的适应证选择、手术技巧和疗效。方法2002年3月至2005年5月对68例患者行关节镜下肩袖重建,其中40例获得随访,以其为研究对象。年龄30~81岁,平均年龄56岁,其中29例发生于主力侧。根据Gerber分型,其中部分肩袖损伤8例,中小型肩袖损伤27例,巨大肩袖损伤5例。手术均采用金属缝合锚(Super-Revo)进行肩袖重建。分别在术前及最终随访时采用美国肩肘医师协会评分(ASES)、Constant-Murley评分以及简易肩关节评分(SST)问卷进行功能评估。结果40例患者获得随访,随访时间12~40个月,平均20.6个月。40例患者手术前及终末随访时ASES平均分为72.6对92.3(P<0.001),其中VAS疼痛评分平均为6.2对1.8(P<0.001),肩关节平均前屈上举为74.5°对146.0°(P<0.001),平均外旋为27.8°对38.3°(P<0.01),ASES评分为优和良所占的比例为92.5%(37/40),平均Constant-Murley评分为69.6对90.4(P<0.001),Constant-Murley评分为优和良所占的比例为90.0%(36/40)。结论肩关节镜下肩袖重建手术具有损伤小、肩关节功能恢复快等特点,尤其在保护三角肌方面具有独到的优势,是治疗肩袖损伤的有效方法之一。正确的适应证选择、熟练的关节镜下操作技术以及术后严格的功能康复锻炼是手术成功的关键。     

肱二头肌长头腱转位上关节囊重建治疗巨大不可修复性肩袖撕裂的生物力学与临床研究

目的:探讨采用关节镜下肱二头肌长头腱（long head of biceps tendon,LHBT）转位上关节囊重建治疗巨大不可修复性肩袖撕裂（massive irreparable rotator cuff tear,MIRCT）时LHBT远端切断对生物力学和临床疗效的影响。方法:取8具新鲜成人肩关节尸体标本,切断...     

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Purpose

Osteoarthritis in combination with rotator cuff deficiency following previous shoulder stabilisation surgery and after failed surgical treatment for chronic anterior shoulder dislocation is a challenging condition. The aim of this study was to analyse the results of reverse shoulder arthroplasty in such patients.

Methods

Thirteen patients with a median follow-up of 3.5 (range two to eight) years and a median age of 70 (range 48–82) years were included. In all shoulders a tear of at least one rotator cuff tendon in combination with osteoarthritis was present at the time of arthroplasty. The Constant score, shoulder flexion and external and internal rotation with the elbow at the side were documented pre-operatively and at the final follow-up. Pre-operative, immediate post-operative and final follow-up radiographs were analysed. All complications and revisions were documented.

Results

Twelve patients were either satisfied or very satisfied with the procedure. The median Constant score increased from 26 points pre-operatively to 67 points at the final follow-up (p = 0.001). The median shoulder flexion increased significantly from 70° to 130° and internal rotation from two to four points (p = 0.002). External rotation did not change significantly (p = 0.55). Glenoid notching was present in five cases and was graded as mild in three cases and moderate in two. One complication occurred leading to revision surgery.

Conclusions

Reverse arthroplasty leads to high satisfaction rates for patients with osteoarthritis and rotator cuff deficiency who had undergone previous shoulder stabilisation procedures. The improvements in clinical outcome as well as the radiographic results seem to be comparable with those of other studies reporting on the outcome of reverse shoulder arthroplasty for other conditions.     

Outcomes after arthroscopic repair of rotator cuff tears in the setting of mild to moderate glenohumeral osteoarthritis

BACKGROUNDRotator cuff pathology is a very common source of shoulder pain. Similarly, osteoarthritis of the glenohumeral joint can cause shoulder pain and produce similar symptoms. Surgical management can be indicated for both pathologies, however, outcomes data is limited when examining rotator cuff repair (RCR) in the setting of glenohumeral arthritis (GHOA). Thus, this study sought to determine outcomes for patients who undergo RCR in the setting of GHOA.AIMTo evaluate if a relationship exists between outcomes of RCR in the setting of GHOA.METHODSThis was a retrospective analysis of patients who underwent arthroscopic rotator cuff repair with concurrent glenohumeral osteoarthritis between 2010-2017. Patients were stratified based on rotator cuff tear size and glenohumeral osteoarthritis severity. Cohorts were paired 1:1 with patients without glenohumeral osteoarthritis. Patients included had a minimum two year follow-up. Rate of conversion to total shoulder arthroplasty, complication rates following initial surgery, and patient-reported outcome measures were collected.RESULTSA total of 142 patients were included. The number of patients that required total shoulder arthroplasty within two years after index surgery was low. 2/71 (2.8%) patients with GHOA, and 1/71 (1.4%) without GHOA. Following rotator cuff repair, both groups showed favorable patient-reported outcomes.CONCLUSIONPatients with glenohumeral osteoarthritis who underwent arthroscopic rotator cuff repair showed comparable outcomes to patients without glenohumeral osteoarthritis.     

超声检查对肩袖损伤的诊断价值

目的 探讨超声检查对肩袖损伤的诊断价值。方法 具有肩撞击综合征和（或）肩袖损伤体征患者53例56肩，男32例34肩，女21例22肩；年龄38-75岁，平均52岁。行超声检查和开放手术或关节镜治疗。通过超声检查对肩袖损伤进行分型，并与开放手术或关节镜所见进行比较。结果 超声检查诊断肩袖损伤32肩，诊断正常肩袖24肩；手术诊断肩袖损伤33肩，诊断正常肩袖23肩。超声检查诊断的灵敏度为90．91％，特异度为91_30％，阳性预测值为93．75％，阴性预测值为87．50％。广泛和大面积肩袖损伤，超声检查诊断6肩，手术诊断6肩；中、小面积全层损伤，超声检查诊断10肩，手术诊断11肩；肩峰面部分损伤，超声检查诊断5肩，手术诊断5肩；关节面部分损伤，超声检查诊断11肩，手术诊断11肩。手术切开修补12肩，关节镜辅助探查有限切开修补16肩，关节镜下断端射频紧缩6肩，关节镜下肩峰成形术22肩。结论 超声检查在诊断肩袖损伤方面具有较高的精确度，尤其适用于诊断肩袖全层损伤。     

Failed prior rotator cuff repair is associated with worse clinical outcomes after reverse total shoulder arthroplasty

BackgroundThe purpose of this study is to determine the comparative risk profile and clinical outcomes for patients undergoing reverse total shoulder arthroplasty (RTSA) for cuff tear arthropathy (CTA) without failed prior rotator cuff repair (RCR) compared with RTSA for CTA with prior RCR.MethodsFrom 2006 to 2014, all patients who underwent RTSA by two surgeons after failed RCR with minimum 2-year follow-up were identified. Patients who underwent RTSA with failed prior RCR were matched in a 1:1 ratio to patients undergoing primary RTSA, while controlling for demographic factors, prosthesis design, and surgeon. Postoperative active forward elevation and active external rotation were recorded. Outcome measures included American Shoulder and Elbow Surgeons score, Visual Analog Scale (VAS), and Simple Shoulder Test. Perioperative complications and rates of secondary reoperation were noted, and comparative multivariate analysis was performed.ResultsOf 262 patients, 192 (73.3%) were available at minimum 2-year follow-up. The prior RCR group had a significantly higher complication rate (17.4%, n = 15) than the primary RTSA group (3.8%, n = 4) (P = .001), although no significant difference in periprosthetic infection (P = .469) or secondary revision rate (P = .136) was observed. At mean 36.3 ± 26.1-month follow-up, the prior RCR group had statistically worse American Shoulder and Elbow Surgeons score (P < .001), VAS (P = .001), Simple Shoulder Test (P < .001), and active forward elevation (P = .006). Patients with multiple failed RCR attempts (n = 38) before RTSA demonstrated no significant differences versus isolated failed RCR (n = 48; P > .05).ConclusionThis study demonstrated that patients with RTSA after prior failed RCR have significantly worse patient-reported outcomes and greater rate of perioperative complications than patients undergoing primary RTSA for CTA.     

肩袖部分撕裂的诊断和治疗

目的探讨肩袖部分撕裂的诊断和手术方法。方法1999年4月~2004年1月,我所对14例肩袖部分撕裂进行手术治疗。术前均拍摄肩关节正位和冈上肌出口位X线片,11例B超检查,14例MR I或MRA检查。5例行肩峰下间隙减压及肩袖清理术;9例行肩峰下间隙减压及肩袖修复术。采用UCLA肩关节评分标准进行评价。结果滑囊侧部分撕裂7例,关节侧部分撕裂7例。14例随访1~6年,平均38个月,UCLA评分由术前(15.9±3.9)分升至术后(30.9±5.2)分(t=15.000,P=0.000)。良13例,差1例;13例满意。结论关节镜检查是诊断肩袖部分撕裂的可靠方法。肩袖修复术是治疗肩袖部分撕裂的有效方法。关节镜下手术创伤小、恢复快。     

Role of shoulder gradient in the pathogenesis of rotator cuff tears

BACKGROUND Shoulder gradient has been associated with shoulder pathologies such as shoulder impingement syndrome.AIM To investigate if there is an association between shoulder gradient and incidence of rotator cuff tear(RCT).METHODS A total of 61 patients with a confirmed diagnosis of RCT were included in this retrospective study. The anteroposterior radiograph of the shoulder was used to measure shoulder gradient in adduction and neutral rotation positions. The pain level was assessed with the visual analog scale for pain.RESULTS The mean age of the patients was 55.7 ± 12.3 years. The mean visual analog scale of the patients was 4.1 ± 1.2. The mean shoulder gradient was 14.11°± 2.65° for the affected shoulder and 15.8°± 2.2° for the unaffected shoulders. This difference was not statistically significant(P = 0.41). A difference of 1.15°± 1.82° was found between the injured and non-injured shoulder. No significant association was found between the gradient difference of the shoulder and demographic and clinical characteristics of the patients.CONCLUSION Shoulder gradient is not associated with the pathology of RCT. Yet, future studies with more standardization and a larger sample size are needed to investigate the role of shoulder gradient in RCT pathogenesis further.     

Treatment of massive irreparable rotator cuff tears without arthritis: a comparison of superior capsular reconstruction,partial rotator cuff repair,and reverse total shoulder arthroplasty

BackgroundTo compare outcomes of superior capsular reconstruction (SCR), partial rotator cuff repair (PR), and reverse total shoulder arthroplasty (rTSA) for massive irreparable rotator cuff tear (MIRCT) without arthritis at more than 2 years follow-up.MethodsA retrospective analysis of prospectively collected data of consecutive patients undergoing surgical treatment for intraoperatively confirmed MIRCT without arthritis using SCR, PR, or rTSA. Preoperative and postoperative data were collected and multivariate analysis performed.ResultsThirty two patients met inclusion criteria for SCR, 24 for PR, and 42 for rTSA (mean follow-up years: SCR 3.2; PR 4.0; rTSA 3.5; P = .02). The rTSA patients were older (66.2 years; SCR 57.3; PR 59.0; P = .0001) and more likely to be female (61.9%; SCR 12.5%; PR 25.0%; P < .001). Intraoperative evaluation demonstrated full thickness subscapularis tear in 37.5% for SCR, 4.2% for PR, and 21.4% for rTSA (P = .01). Pseudoparalysis was present in 18.8% of SCR, 0% of PR, and 14.3% of rTSA patients (P = .08). All groups saw postoperative improvement in strength and patient-reported outcomes (P < .036). SCR and rTSA demonstrated an improved forward elevation range of motion (ROM) postoperatively while PR did not (P = .96). No group experienced improvement in rotation ROM (P > .12). rTSA had worse postoperative ROM in all planes compared to SCR and PR (P < .003). There were no differences between groups in postoperative strength (P > .16) or patient-reported outcomes (American Shoulder and Elbow Surgeons P = .14; visual analog scale P = .86; single assessment numeric evaluation P = .61). Patients were satisfied in 81.2% of SCR cases, 87.5% of PR, and 95.3% of rTSA (P = .33). Three of 32 (9.4%) SCR patients required conversion to rTSA, while 3 of 24 (12.5%) PR patients required reoperation (2 revision repairs; 1 conversion to rTSA). There were 3 additional surgical complications among 42 rTSA patients (7.1%). There were 4 nonsurgical complications in the SCR group and 1 in the rTSA group. One SCR patient and 3 rTSA patients were deceased. Multivariate analysis demonstrated no independent predictors of revision surgery. An increased acromiohumeral interval distance was an independent predictor of improved postoperative strength for all groups (P < .02).ConclusionSCR, PR, and rTSA for the treatment of MIRCT without arthritis all significantly improved postoperative strength and outcomes scores with >80% patient satisfaction but with rTSA having worse postoperative motion and a higher complication rate. There were no independent predictors for revision surgery. SCR, PR and rTSA are all viable operations for MIRCT without arthritis with satisfactory results maintained at 2 years postoperatively.