Related Experiment Video
Updated: Mar 17, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Immediate reverse shoulder arthroplasty demonstrates better outcomes than salvage reverse shoulder arthroplasty for
Xinxin Du1,2, Rui Han1, Hua Li3
1Department of Foot & Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, China.
Background:
Reverse shoulder arthroplasty (RSA) is a promising option for proximal humerus fractures (PHFs) and also used as a salvage procedure for failed treatment. Whether the timing of RSA would influence the clinical outcomes is controversial. This meta-analysis compared outcomes between immediate RSA (iRSA) and salvage RSA (sRSA) in geriatric patients with PHFs.
Methods:
PubMed, Embase, Web of Science and Cochrane Library databases were searched up to 1st April 2024. Comparative studies reporting outcomes of iRSA and sRSA in geriatric patients with PHFs were included. A random-effects model was used for meta-analysis. The primary outcome was the revision rate. Secondary outcomes included shoulder function and complications. Risk ratios (RR) were calculated for dichotomous outcomes, and weighted mean differences (WMDs) were used for continuous variables. Meta-regression model and subgroup analysis were used to explore sources of potential heterogeneity for the primary outcome.
Results:
Seventeen studies with 27,756 cases (24442 receiving iRSA and 3314 receiving sRSA) were included. Compared with sRSA, iRSA was associated with a lower risk of revision (RR = 0.41, P < 0.001), greater range of motion (ROM) (abduction: WMD = 11.32°, P < 0.001; forward flexion: WMD = 11.51°, P < 0.001; external rotation: WMD = 3.77°, P = 0.048) and statistically superior shoulder functional scores (Constant-Murley score: WMD = 5.57, P < 0.001; American Shoulder and Elbow Surgeons score: WMD = 10.38, P < 0.001; Simple Shoulder Test score: WMD = 0.91, P = 0.001; Shoulder Pain and Disability Index: WMD = - 14.50, P < 0.001), and lower risk of complications (infection: RR = 0.42, P = 0.019; dislocation: RR = 0.34, P = 0.007; nerve palsy: RR = 0.49, P = 0.026). The meta-regression model and subgroup analysis showed that sRSA after failed prior surgery had the highest revision rate (9.4%) as compared with iRSA (3.7%).
Conclusions:
In elderly patients with PHFs, iRSA is associated with lower revision and complication rates, as well as statistically superior shoulder function and ROM, compared with sRSA. However, the clinical significance of some functional differences remains uncertain.
Trial Registration:
CRD42024534751.
More Related Videos
05:25Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
07:22Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025