Patients 75 years or older with primary glenohumeral arthritis and an intact rotator cuff show similar clinical improvement after reverse or anatomic total shoulder arthroplasty

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dc.authoridArdebol, Javier/0000-0003-1573-5002
dc.authoridFlores Villalobos, Adrian/0000-0002-1903-1216
dc.authoridDenard, Patrick/0000-0002-2641-5920
dc.authoridKILIC, Ali Ihsan/0000-0001-7491-6044
dc.contributor.authorArdebol, Javier
dc.contributor.authorFlores, Adrian
dc.contributor.authorKilic, Ali Ihsan
dc.contributor.authorPak, Theresa
dc.contributor.authorMenendez, Mariano E.
dc.contributor.authorDenard, Patrick J.
dc.date.accessioned2025-03-20T09:51:08Z
dc.date.available2025-03-20T09:51:08Z
dc.date.issued2024
dc.departmentİzmir Bakırçay Üniversitesi
dc.description.abstractBackground: The optimal management of primary glenohumeral arthritis (GHOA) in the elderly is an ongoing topic of debate. The purpose of this study was to compare functional outcomes and complications in patients aged 75 years or older treated with anatomic total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA) for primary GHOA with an intact rotator cuff. Methods: A retrospective study was performed on a prospectively maintained database which was queried for patients 75 years of age or older who underwent TSA or RSA for primary GHOA with an intact rotator cuff at a single institution between 2012 and 2021 with minimum 2 -year follow-up. Patient -reported outcomes (PROs), including Visual Analog Scale for pain, American Shoulder and Elbow Surgeons, and Subjective Shoulder Value, as well as active range of motion including forward flexion, external rotation, internal rotation, were collected preoperatively and postoperatively. Complications, reoperations, and satisfaction were also recorded. The percentage of patients achieving clinically significant improvement was evaluated with the minimally clinical important difference, substantial clinical benefit, and patient acceptable symptomatic state for each PRO. Results: One -hundred and 4 patients were available for analysis, including 67 TSA patients and 37 RSAs with a mean follow-up of 39.4 months. Preoperative baseline characteristics, PROs, and range of motion were similar between groups. RSA was more commonly performed for eccentric glenoid wear (Walch B2/B3, 62% vs. 22%; P < .001). While clinical outcomes improved comparably in both groups, the TSA cohort showed significantly greater improvement in external rotation (36 degrees vs. 26 degrees ; P = .013). Both cohorts had low revision (3% for TSA vs. 0% for RSA) and complication (7% for TSA vs. 5% for RSA; P = .677) rates. Satisfaction was similar in both groups (93% for TSA vs. 92% for RSA; P = .900). Clinically significant improvement was comparable between groups based on the American Shoulder and Elbow Surgeons score (minimally clinical important difference, 93% for TSA vs. 100% for RSA; substantial clinical benefit, 82% vs. 95%; patient acceptable symptomatic state, 67% vs. 78%; P > .05). Conclusion: In this retrospective small sample size comparison study, TSA and RSA provide similar short-term clinical outcomes for patients 75 years and older with primary GHOA and an intact rotator cuff. Complication and revision rates are comparably low at shortterm follow-up. Our data suggests that advanced age alone should not be used as a decision -making tool for TSA vs. RSA in the setting of primary GHOA with an intact rotator cuff. Level of evidence: Level III; Retrospective Cohort Comparison; Treatment Study (c) 2023 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
dc.identifier.doi10.1016/j.jse.2023.10.021
dc.identifier.endpage1260
dc.identifier.issn1058-2746
dc.identifier.issn1532-6500
dc.identifier.issue6
dc.identifier.pmid38072034
dc.identifier.scopus2-s2.0-85185599144
dc.identifier.scopusqualityQ1
dc.identifier.startpage1254
dc.identifier.urihttps://doi.org/10.1016/j.jse.2023.10.021
dc.identifier.urihttps://hdl.handle.net/20.500.14034/2441
dc.identifier.volume33
dc.identifier.wosWOS:001242603900001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMosby-Elsevier
dc.relation.ispartofJournal of Shoulder and Elbow Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20250319
dc.subjectTotal shoulder arthroplasty
dc.subjectreverse shoulder arthroplasty
dc.subjectelderly
dc.subjectosteoarthritis
dc.subjectprimary
dc.subjectintact rotator cuff
dc.titlePatients 75 years or older with primary glenohumeral arthritis and an intact rotator cuff show similar clinical improvement after reverse or anatomic total shoulder arthroplasty
dc.typeArticle

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