Humeral Component Version Has No Effect on Outcomes Following Reverse Total Shoulder Arthroplasty: A Prospective,...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Controversy exists regarding optimal humeral component version for reverse total shoulder arthroplasty (rTSA).
• Humeral version impacts shoulder rotation and patient outcomes.
• Understanding optimal component placement is crucial for rTSA success.

Purpose of the Study:

• To determine if humeral component version affects shoulder rotation and strength post-rTSA.
• To compare outcomes between neutral and 30° retroversion of the humeral component.
• To evaluate the impact of humeral version on patient-reported scores and complications.

Main Methods:

• Randomized trial comparing neutral versus 30° retroversion for humeral component placement in rTSA.
• Assessed active range of motion, muscle strength, and patient-reported outcomes (VAS, ASES, PROMIS-10) up to two years.
• Included patients with rotator cuff tear arthropathy, massive rotator cuff tears, or osteoarthritis with rotator cuff tears.

Main Results:

• No significant differences in active shoulder rotation (internal/external), elevation, or strength between groups at two years.
• Similar improvements in pain (VAS), function (ASES), and quality of life (PROMIS-10) were observed.
• Complication rates, including instability, stiffness, and acromial stress fractures, were comparable. Scapular notching incidence was similar.

Conclusions:

• Humeral component placement at neutral or 30° retroversion yields comparable functional outcomes and patient satisfaction in rTSA.
• Neither version demonstrated a significant advantage in range of motion, strength, or pain relief.
• The findings suggest flexibility in humeral component version selection for rTSA.