The role of individual preoperative planning in the quality of life of patients with reverse shoulder arthroplasty

Introduction. Reverse shoulder arthroplasty remains a technically difficult operation. Incorrect positioning of components can lead to some complications, which in turn reduces the quality of life of patients, and, according to various authors, creates from 4.7% to 32% [1-6]. Computer-aided preoperative 3D planning and individual guides are used for reduce the risk of this type of complication.Goal. assessment of the quality of life of patients after reverse shoulder arthroplasty with individual preoperative 3D planning.Methods. Evaluation of the results of treatment 50 patients after primary reverse shoulder arthroplasty (32 women - 64% and 18 men - 36%) in University Clinical Hospital No. 1 of the I.M. Sechenov First Moscow State Medical University (Sechenov University) operated on from 2018 to 2020. The average age of the patients was ± 64 years. The criteria for inclusion in the studies were: 1) the age of patients over 18 years; 2) the patient has a diagnosis of deforming or post-traumatic arthrosis of the shoulder joint; 3) dysfunction of the upper limb. Exclusion criteria: 1) age: up to 18 years old; 2) pregnancy, breastfeeding;3) the presence of concomitant diseases (ASA III and higher); 4) dysfunction of the deltoid muscle. All patients underwent Rg of the shoulder joint, pain was assessed using the visual analog pain scale, and the function of the upper limb was assessed using the Constant and UCLA scales at 3, 6 and 12 months after surgery.Results. In the main group of patients, the average range of motion of the shoulder joint was greater than in the control group in all observation periods: abduction ± 7.5 degrees, anterior flexion ± 8 degrees, external and internal rotations ± 2.5 degrees. The result of the main group in comparison with the control group on the Constant-Murley scale was higher on average by 3.5 points, and on the UCLA scale by 2 points for the entire observation period. Conclusions. This study showed that the use of the individual preoperative planning tactics developed by us improves the function of the upper limb and the quality of life of patients after reverse shoulder arthroplasty. However, more extensive and long-term studies of this technique are needed to assess the results in the later postoperative periods.