Anatomic versus reverse shoulder arthroplasty: a mid-term follow-up comparison

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.