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Patients achieved improvements in outcomes 2 years after TSA, reverse TSA
Although both anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty improved patient outcomes at 2-year follow-up, anatomic total shoulder arthroplasty more reliably improved range of motion, according to results.
Joseph D. Zuckerman, MD, and colleagues recorded simple shoulder test, University of California, Los Angles (UCLA) shoulder, American Shoulder and Elbow Surgeons (ASES), Constant and shoulder pain and disability index (SPADI) scores, along with range of motion, preoperatively and at routine postoperative time points among 1,183 patients who underwent either anatomic total shoulder arthroplasty (TSA, n=505) or reverse TSA (n=678) with a single-platform shoulder system (Equinoxe, Exactech). Patients included in the study had a minimum follow-up of 2 years, and researchers compared recovery between the two groups.
Results showed greater improvements in the Constant score and active forward flexion among patients who underwent reverse TSA, and better improvements in external rotation among patients who underwent anatomic TSA at nearly all time points. Researchers found a decrease in improvement in flexion and abduction for each prostheses type by 72 months, particularly among patients who underwent reverse TSA. Although most patients achieved improvement at 6 months postoperatively, full improvement was achieved by 24 months, with all five scoring metrics following a similar rate of improvement. Researchers noted the ASES, SPADI and UCLA shoulder scores closely mirrored each other in the magnitude of improvements. For both anatomic TSA and reverse TSA, results showed the largest improvement in the simple shoulder test and the smallest improvement in the Constant score.
“This clinical study is significant because it is the largest single-prosthesis total shoulder arthroplasty outcome study published to date which demonstrates that both anatomic and reverse total shoulder arthroplasty are effective treatments for various degenerative conditions of the shoulder, with some differences noted between the prosthesis types, which are primarily attributed to the differing pathologies and patient demographics,” Zuckerman told Healio.com/Orthopedics. – by Casey Tingle
Disclosures: Zuckerman reports receiving other support and personal fees from Exactech Inc. and has patent 9,233,033 and 8,870,962 issued. Please see the full study for a list of all other authors’ relevant financial disclosures.