Reverse total shoulder replacement

An August 2022 paper (1) compared Reverse total shoulder arthroplasty replacement with standard total shoulder arthroplasty (replacement). These are the findings: “Reverse total shoulder arthroplasty (Reverse total shoulder arthroplasty replacement), which was originally designed mainly for irreparable rotator cuff damage, has gained popularity in recent years for the treatment of advanced shoulder osteoarthritis instead of the clinically standard total shoulder arthroplasty (replacement). However, this Reverse total shoulder arthroplasty has some nonnegligible flaws such as higher complications rate and economic cost, not mention the following problems caused by irreversible physical structural damage. Therefore, the employment of Reverse total shoulder arthroplasty needs to be carefully considered.”

In this study of 57,156 shoulder arthroplasties, “Reverse total shoulder arthroplasty patients in the rotator cuff deficiency group had significant higher transfusion rates and longer hospital stays. Reverse total shoulder arthroplasty patients without rotator cuff deficiency had a statistically significantly higher number of implant-related mechanical complications, acute upper respiratory infections and postoperative pain. Overall, Reverse total shoulder arthroplasty incurred higher costs in both groups. For osteoarthritis patients with rotator cuff deficiencies, Reverse total shoulder arthroplasty has its benefits as complication rates were comparable to total shoulder arthroplasty. For those patients without rotator cuff deficiencies, the use of Reverse total shoulder arthroplasty should be reconsidered as there were more complications with higher severity.”

1 Liu H, Huang TC, Yu H, Wang Y, Wang D, Long Z. Total shoulder arthroplasty versus reverse total shoulder arthroplasty: Outcome comparison in osteoarthritis patients with or without concurrent rotator cuff deficiency. Medicine (Baltimore). 2022 Aug 12;101(32):e29896.

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