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Reverse Total Shoulder Arthroplasty
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Anatomic versus reverse shoulder arthroplasty: a mid-term follow-up comparison.

Bradley S Schoch1, Joseph J King2, Joseph Zuckerman3

  • 1Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA.

Shoulder & Elbow
|October 18, 2021
PubMed
Summary

Reverse shoulder arthroplasty (RSA) shows fewer complications and reoperations than anatomic total shoulder arthroplasty (ATSA) in mid-to-long-term follow-up. Patients with RSA reported higher satisfaction despite similar functional outcomes.

Keywords:
Reverse shoulder arthroplastyanatomic shoulder arthroplastylong termoutcomesshoulder arthroplastytotal shoulder arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Musculoskeletal Research

Background:

  • Anatomic total shoulder arthroplasty (ATSA) offers pain relief and functional improvement.
  • Reoperation rates for ATSA are approximately 1% annually.
  • Reverse shoulder arthroplasty (RSA) may offer superior outcomes due to improved glenoid fixation.

Purpose of the Study:

  • To compare functional outcomes and reoperation rates of ATSA versus RSA.
  • To evaluate mid-to-long-term results (minimum 8 years) of both arthroplasty types.
  • To assess patient satisfaction and complication rates between ATSA and RSA.

Main Methods:

  • Retrospective review of 187 shoulders (137 ATSA, 50 RSA) between 2005-2010.
  • Mean follow-up of 8.8 years.
  • Evaluated range of motion, Simple Shoulder Test, Constant score, ASES, UCLA score, and SPADI.

Main Results:

  • ATSA showed greater overhead range of motion and external rotation.
  • Patient-reported outcomes were similar between groups.
  • RSA had significantly fewer complications (8% vs 24%) and reoperations (4% vs 23%) than ATSA.
  • 90% of RSA patients reported 'much better' or 'better' outcomes compared to 67% of ATSA patients.

Conclusions:

  • RSA demonstrates superior safety profiles with fewer complications and reoperations compared to ATSA at mid-to-long-term follow-up.
  • While functional outcomes are comparable, RSA leads to higher patient satisfaction.
  • RSA is a viable alternative to ATSA, particularly regarding revision rates.