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Anatomic versus reverse total shoulder arthroplasty outcomes after prior contralateral anatomic total shoulder arthroplasty in patients with bilateral primary osteoarthritis with an intact rotator cuff.

Authors :
Turnbull, Lacie M.
Hao, Kevin A.
Bindi, Victoria E.
Wright, Jonathan O.
Wright, Thomas W.
Farmer, Kevin W.
Vasilopoulos, Terrie
Struk, Aimee M.
Schoch, Bradley S.
King, Joseph J.
Source :
International Orthopaedics. Mar2024, Vol. 48 Issue 3, p801-807. 7p.
Publication Year :
2024

Abstract

Purpose: We aimed to compare outcomes in patients that underwent bilateral anatomic total shoulder arthroplasty (aTSA) vs. aTSA/ reverse total shoulder arthroplasty (rTSA) for rotator cuff-intact glenohumeral osteoarthritis (RCI-GHOA) to further elucidate the role of rTSA in this patient population. Methods: A single-institution prospectively collected shoulder arthroplasty database was reviewed for patients undergoing bilateral total shoulder arthroplasty (TSA) for RCI-GHOA with a primary aTSA and subsequent contralateral aTSA or rTSA. Outcome scores (SPADI, SST, ASES, UCLA, Constant) and active range of motion (abduction, forward elevation [FE], external and internal rotation [ER and IR]) were evaluated. Clinically relevant benchmarks (minimal clinically important difference [MCID], substantial clinical benefit [SCB], and patient acceptable symptomatic state [PASS]) were evaluated against values in prior literature. Incidence of surgical complications and revision rates were examined in qualifying patients as well as those without <two year follow-up. Results: Of the 55 bilateral TSA patients with an intact rotator cuff, 46 underwent aTSA/aTSA and 9 underwent aTSA/rTSA. At the time of the second TSA, patients undergoing aTSA/rTSA were older (71 ± 4 vs. 67 ± 7, P =.032) and more commonly had inflammatory arthritis (44% vs. 11%, P =.031). Mean time to the second TSA was shorter for aTSA/aTSA (2.3 ± 2.8 vs. 4.4 ± 3.6 years, P <.001). Postoperative outcomes were similar after the first aTSAs between groups with similar proportions achieving the MCID, SCB, and PASS (all P >.05). The 2nd TSAs between groups were similar preoperatively, but aTSA/rTSA had superior outcome scores, overhead motion, and active abduction compared to patients that underwent aTSA/aTSA. There were no differences in active ER and IR scores or complication rates between groups. Conclusion: Patients with RCI-GHOA have excellent clinical outcomes after either aTSA/aTSA or aTSA/rTSA. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03412695
Volume :
48
Issue :
3
Database :
Academic Search Index
Journal :
International Orthopaedics
Publication Type :
Academic Journal
Accession number :
175719298
Full Text :
https://doi.org/10.1007/s00264-023-06044-w