Simultaneous versus staged bilateral shoulder replacement: a matched cohort study

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Biomedical Engineering

Background:

• The safety and clinical value of simultaneous bilateral shoulder arthroplasty (SimBA) are not well-established.
• This study compares SimBA to staged bilateral shoulder arthroplasty (StaBA) in a matched-cohort design.

Purpose of the Study:

• To investigate the safety and clinical outcomes of SimBA versus StaBA.
• To compare complication rates, reoperation rates, range of motion, and patient-reported outcomes.

Main Methods:

• Retrospective matched-cohort study of patients undergoing SimBA or StaBA for various shoulder conditions.
• Patients were matched by age, gender, ASA score, and arthroplasty type.
• Data collected included demographics, complications, length of stay, range of motion, Constant score, and Subjective Shoulder Value (SSV).

Main Results:

• No significant differences in complications, reoperations, or patient-reported outcomes (SSV) between SimBA and StaBA groups.
• SimBA group had a significantly shorter total length of stay (3.4 vs 7.5 days).
• All SimBA patients reported willingness to undergo the procedure again and recommend it.

Conclusions:

• Simultaneous bilateral shoulder arthroplasty is a safe and effective option for carefully selected patients (age ≤80, ASA ≤2, good social support).
• SimBA reduces total length of stay while achieving equivalent outcomes and complication rates compared to staged surgery.
• Treatment decisions should be collaborative, involving the surgeon, anesthesiologist, and patient.