Outcomes after shoulder replacement: comparison between reverse and anatomic total shoulder arthroplasty

Area of Science:

• Orthopedic surgery
• Arthroplasty
• Shoulder reconstruction

Background:

• Anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) are common surgical options for shoulder arthritis.
• While TSA is standard for arthritis with an intact rotator cuff, RTSA has variable complication rates and outcomes.
• This study compares TSA and RTSA in side-by-side patient cohorts.

Purpose of the Study:

• To compare the clinical outcomes and complication rates of TSA versus RTSA.
• To evaluate patient-reported outcomes and range of motion following TSA and RTSA.

Main Methods:

• Prospective, case-control study involving 47 patients for TSA and 53 for RTSA.
• Follow-up averaged over 2 years, assessing major complications (infection, fracture, instability, loosening, revision).
• Outcome measures included the American Shoulder and Elbow Surgeons score, pain VAS, and range of motion; radiographic analysis was also performed.

Main Results:

• No significant difference in major complication rates (TSA 15%, RTSA 13%) or revision surgery rates (TSA 11%, RTSA 9%) at 2 years.
• Similar patient-reported outcomes (ASESS, VAS) between TSA and RTSA groups.
• TSA demonstrated significantly greater external rotation (53° vs. 38°) compared to RTSA; other motion measures were comparable.

Conclusions:

• TSA and RTSA exhibit similar complication rates, revision needs, and patient-reported outcomes at the 2-year follow-up.
• Both shoulder arthroplasty procedures provide comparable range of motion, with TSA excelling in external rotation.
• Standardized comparison in side-by-side cohorts supports the similar efficacy of TSA and RTSA for specific shoulder conditions.