Anatomic and Reverse Total Shoulder Arthroplasty in Patients Older Than 80 Years

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Biomedical Engineering

Background:

• Anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RSA) are common procedures for elderly patients.
• Patients often lack awareness of the distinct outcomes associated with TSA versus RSA.

Purpose of the Study:

• To compare the outcomes of primary TSA and RSA in patients aged 80 years and older.
• To highlight differences in functional scores, range of motion, and complication rates between the two procedures.

Main Methods:

• A consecutive series of patients aged 80+ undergoing primary TSA (n=18) or RSA (n=33) with at least 2-year follow-up were evaluated.
• Preoperative and postoperative assessments included pain, function scores, range of motion, complications, transfusion rates, and patient satisfaction.

Main Results:

• Both TSA and RSA demonstrated similar effectiveness in improving pain, function, and range of motion.
• Patients undergoing TSA reported significantly higher satisfaction, better American Shoulder and Elbow Society scores, and superior forward elevation and external rotation.
• RSA had higher rates of transfusion and postoperative complications, with fewer patients achieving good to excellent results.

Conclusions:

• TSA and RSA provide comparable improvements in pain, function, and motion for patients over 80.
• TSA is associated with greater patient satisfaction and better functional outcomes compared to RSA in this age group.
• While both procedures are effective, RSA carries a higher risk of complications and lower likelihood of excellent outcomes.