Comparison of outcomes using anatomic and reverse total shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Total shoulder arthroplasty (TSA) usage, including anatomic (aTSA) and reverse (rTSA) types, is increasing globally.
• Predictable outcomes contribute to the rising popularity of both aTSA and rTSA procedures.
• A single platform system allows for both aTSA and rTSA using identical humeral components and instrumentation.

Purpose of the Study:

• To quantify and compare outcomes of aTSA and rTSA using five distinct metrics.
• To evaluate the efficacy of a single platform TSA system for both aTSA and rTSA.
• To assess functional improvements and range of motion following aTSA for osteoarthritis and rTSA for rotator cuff tear arthroplasty.

Main Methods:

• A prospective study involving 200 patients undergoing either aTSA (n=73) or rTSA (n=127).
• Patients were treated by two orthopedic surgeons for osteoarthritis (aTSA) or rotator cuff tear arthroplasty (rTSA).
• Outcomes were assessed preoperatively and at latest follow-up (mean 31.4 months) using SST, UCLA, ASES, Constant, and SPADI metrics, alongside motion quantification.

Main Results:

• Both aTSA and rTSA demonstrated significant improvements in pain and function.
• No instability or glenoid loosening occurred; one infection in the rTSA group.
• aTSA yielded higher pre/postoperative scores and range of motion, while rTSA showed greater improvements in scores, forward flexion, and strength.

Conclusions:

• A single platform TSA system effectively improved outcomes for both aTSA and rTSA at a mean follow-up of 31.4 months.
• Significant differences were noted between prosthesis types and scoring metrics (Constant and ASES).
• Longer-term follow-up is necessary to validate observed differences between aTSA and rTSA outcomes.