**4. Outcome quantification**

The language of RTSA outcomes is a complex task given the wide range of outcomes metrics. The most common scoring methods include the following: Range of Motion (ROM), Constant-Murley Score (CMS), American Surgeons of Elbow and Shoulder score (ASES), Visual Analogue Score (VAS), and the Simple Shoulder Test (SST). Other methods include but are not limited to the UCLA Shoulder Score and the Shoulder Pain and Disability Index (SPADI) [17–19]. The CMS, first published in 1987, is comprised of four sections: two of which are self-reported by the patient—pain and activities of daily living, the remaining two are reported by the physician—range of motion and strength [20]. Concerns were raised regarding the score's ability to account for age and gender; thus, the modified version adjusts for both [17]. The ASES was created with the goal of developing a universal outcome measure; it too contains patient-reported and physician-reported parts. In addition, the ASES has demonstrated appropriate validity and reliability in assessing operative and non-operative interventions for shoulder pathology [17]. However, it's appraisal of functionality may be somewhat limited among the older adult population; for example, the questions about "do usual sport" and "throw ball overhand" may not be relevant [19]. Patient-reported pain is an outcome that necessitates acknowledgement, which may be quantified by utilizing the VAS [21]. The VAS uses a line measuring 100 mm with pain extremes indicated on either end; no pain and worst pain [21]. The patient marks along the continuum where he/she believes their pain is best described; the score is then represented by a distance in millimeters [22]. Finally, the SST, is used to evaluate patient-reported functionality associated with various shoulder pathology, including rotator cuff arthropathy, osteoarthritis, rheumatoid arthritis, and adhesive capsulitis [17, 18]. This questionnaire consists of 12 questions that ask the patient whether he/she may perform the given activity [18].

**Study Sample size**

> 38 77–83 years

> 1147 45–84 years

> 186 23–86 years (72.7 mean)

> 41 46–64 years

> 54 53–81 years

3–60 months

3–36 months

24–150 months

60–171 months

**Alentorn-Geli et al (2017)**

**Anakwenze et al (2016)**

**Bacle et al (2017)**

**Ek et al. (2013)**

**Feeley et al (2014)**

**Age Follow up Complications Component** 

Infection Glenoid loosening Revisions Component Dislocation

Aseptic revision Mortality Surgical site infection Readmission

Dislocation Scapular Notching Infection Nerve Palsy Glenoid Loosening Humeral Loosening Glenoid fracture Revisions

Infection Nerve Palsy Fracture Dislocation Component Wear Glenoid loosening

30 months Scapular

notching

**variability**

Global) Delta reverse shoulder System

(DePuy)

164 Delta III (DePuy) 27 Aequalis (Tournier)

Glenoid component 36mm, 40mm, or 42 mm

Delta III (DePuy) (lateralized humeral polyethylene cup) Anatomical Shoulder System (Zimmer) (6mm medialized humeral

Zimmer Reverse Trabecular Metal System 36mm glenosphere 3mm lateralized

cup)


BMI Diabetes Mellitus Increased age

Comprehensive reverse shoulder system (Biomet) Encore reverse (DJO

Current Outcomes Following Reverse Total Shoulder Arthroplasty: A Composite

**Risk factors Scoring** 

Tobacco use Diabetes Mellitus Hypertension Increased age

http://dx.doi.org/10.5772/intechopen.72545

**Mechanism**

89

FF ER


ROM

CMS Validated electronic dynamometer

ASES score ROM

Increased age CMS

Previous surgery on same shoulder

