Study | Year | Study design | LoE | Rotator cuff tear | Definition | Included patients | Imaging criteria |
---|---|---|---|---|---|---|---|
Ernstbrunner et al. AJSM [16] | 2020 | Case–control study | 3 | Massive RCTs: >2 tendons | Pseudoparalysis: active scapular plane abduction <45° Pseudoparesis: active scapular plane abduction >45° and <90° | n = 50 pseudoparalysis group n = 24 pseudoparesis group n = 26 | Plain radiographs: no difference MRI: fatty infiltration SSC (2.9 vs. 1.6; p < 0.001) and ISP (3.6 vs. 3.0; p < 0.001) muscles; anterior (−23° vs. 4°, p < 0.001), posterior (−23° vs. −14°, p = 0.034) and global RCT extensions (225° vs. 190°, p < 0.001) |
Ernstbrunner et al. AJSM [17] | 2020 | Case–control study | 3 | Massive RCTs: >2 tendons | Pseudoparalysis: active scapular plane abduction <90° | n = 100 pseudoparalysis group n = 50 age- and sex-matched control group n = 50 | Plain radiographs: CSA (38.2° vs. 35.2°, p = 0.001), ACHD (4.7 vs. 7.3, p < 0.001), posterior acromial height (22 vs. 17, p = 0.005), anterior (−9° vs. 25°, p < 0.001) and posterior RCT extension (−18° vs. 2°, p < 0.001) MRI: fatty infiltration SSC (2.2 vs. 1.4, p < 0.001) |
Tokish et al. JSES [44] | 2017 | Systematic Review | 4 | Massive RCT (not exactly defined) | Pseudoparalysis: maintained passive elevation, 0° of active elevation, no neurologic deficit Pseudoparesis: maintained passive elevation, <90° of active elevation, no neurologic deficit | 16 studies 4 studies: no differentiation, <90° active elevation 5 studies: no definition 7 studies: heterogenous definitions | N. A. |
Clinical presentation
Biomechanics
Loss of forward elevation
Bony anatomy
Implications for treatment
Conservative treatment
Surgical treatment
Study | Year | Study design | LoE | Definition | Included patients | Treatment | Imaging criteria | Follow-up | Mean age | Clinical results: forward elevation | Pseudoparalysis reversal |
---|---|---|---|---|---|---|---|---|---|---|---|
Levy et al. JSES [32] | 2008 | Case series | 4 | Pseudoparalysis not defined, free passive motion | n = 17 | Subacromial injection of local anesthetic and long-acting steroid, deltoid re-education | ACHD less than 7 mm, Hamada grade 2 (n = 5), 3 (n = 7), 4 (n = 5) Grade 4 fatty infiltration (SSP & ISP: 100%, SSC: 82%), grade 3 (SSC: 18%) | Minimum: 9 months | 60 years | Preintervention: 40° Postintervention: 160° | 82% |
Oh et al. AJSM [40] | 2011 | Cohort study | 3 | Pseudoparalysis/-paresis: <90° active elevation with free passive motion | n = 29 (Non-pseudoparalytic control group, n = 29) | Arthroscopically assisted mini-open repair, n = 11 All-arthroscopic repair, n = 18 | N. A. | 33 months (control group: 29 months) | 65 years (control group: 65 years) | Preoperative: 64° postoperative: 135° (control group: preoperative: 152° postoperative: 159) | 76% |
Denard et al. Arthroscopy [8] | 2012 | Case series | 4 | Pseudoparalysis: <90° active flexion with free passive motion | n = 53 (group 1: primary, n = 39; group 2: revision, n = 14) | Arthroscopic rotator cuff repair | N. A. | 75 months | 62 years (group 1: 62 years, group 2: 63 years) | Group 1: preoperative: 49° postoperative: 155° group 2: preoperative: 43° postoperative: 109° | Group 1: 90% group 2: 43% |
Denard et al. AJSM [9] | 2015 | Case series | 4 | Pseudoparalysis: <90° active elevation with free passive motion | n = 56 Traumatic: 80% | Arthroscopic rotator cuff repair | Hamada grade 1 (76%), 2 (20%), 3 (2%), 4 (2%) positive tangent sign: 57% fatty infiltration grade ≥3: 16% | 14 months | 63 years | Preoperative: 47° postoperative: 159° | 95% |
Spross et al. Arthroscopy [43] | 2019 | Case series | 4 | Pseudoparesis: <90° active elevation with free passive motion | n = 21 Traumatic: 100% | Arthroscopic rotator cuff repair | Complete 2 tendon tear, <grade 3 fatty infiltration | 39 months | 61 years | Preoperative: 36° postoperative: 165° | 100% |
Birmingham and Nevasier JSES [2] | 2008 | Case series | 4 | Pseudoparalysis not defined, active motion <80°, passive motion >110° | n = 18 | Diagnostic arthroscopy, open latissimus transfer | N. A. | 25 months | 60 years | Preoperative: 56° postoperative: 137° | 100% |
Kanatli et al. Arthroscopy [29] | 2016 | Case series | 4 | Pseudoparalysis: <90° active elevation and abduction | n = 15 | Arthroscopically assisted latissimus dorsi transfer | N. A. | 26 months | 62 years | Preoperative: 58° postoperative: 130° | N. A. |
Elhassan et al. JSES [11] | 2020 | Case series | 4 | Pseudoparalysis: <60° active flexion, <60° active abduction | n = 19 | Arthroscopically assisted lower trapezius transfer | Not specified for pseudoparalytic shoulders | 14 months | 52 years | Not specified for pseudoparalytic shoulders | 95% |
Burkhart and Hartzler Arthroscopy [4] | 2019 | Case series | 4 | Pseudoparalysis: <45° active flexion with free passive motion | n = 10 | Arthroscopically assisted superior capsular reconstruction | Complete 2‑tendon tear, Hamada ≤3 | 13 months | 69 years | Preoperative: 27° postoperative: 159° | 90% |
Mihata et al. AJSM [36] | 2018 | Case series | 4 | Moderate pseudoparalysis: <90° active elevation, maintained >90° elevation after passive elevation Severe elevation: <90° active elevation, positive drop-arm sign | Moderate n = 28 Severe n = 15 (no pseudoparalysis n = 45) | Arthroscopically assisted superior capsular reconstruction | Moderate: Hamada grade 1 (25%), 2 (61%), 3 (11%); fatty infiltration grade 1 (0), 2 (4%), 3 (39%), 4 (57%) Severe: Hamada grade 1 (20%), 2 (67%), 3 (13%); fatty infiltration grade 1 (0), 2 (7%), 3 (27%), 4 (67%) | 60 months | Moderate: 68 years severe: 62 years | Moderate: preoperative: 54° postoperative: 147° Severe: preoperative: 37° postoperative: 150° | Moderate: 96% Severe: 93% |
Valenti et al. CORR [45] | 2011 | Case series | 4 | Pseudoparalysis: <60° active elevation | n = 76 | Reversed total shoulder arthroplasty | SSC: 30% superior third, 2.2 fatty infiltration SSP: 100% rupture, Patte grade 3 retraction, 2.96 fatty infiltration ISP: 2.9 fatty infiltration | 44 months | 73 years | Preoperative: 65° Postoperative: 126° | 100% |
Ernstbrunner et al. JBJS [14] | 2017 | Case series | 4 | Pseudoparalysis: <90° active elevation and abduction | n = 21 | Reversed total shoulder arthroplasty | ACHD <7 mm, fatty infiltration grade >2 | 11.7 years | 57 years | Preoperative: 64° postoperative: 117° | N. A. |
Gerber et al. JSES [25] | 2018 | Case series | 4 | Pseudoparalysis: <90° active elevation and abduction | n = 16 | Reversed total shoulder arthroplasty | ACHD <7 mm, fatty infiltration grade >2 | 16 years | 68 years | Preoperative: 53° postoperative: 101° | N. A. |