Hunter Firment , 2025-04-15 16:39:00
April 15, 2025
2 min read
Key takeaways:
- Outcomes after total shoulder arthroplasty were linked to anatomical accuracy.
- Reverse shoulder arthroplasty did not show any relationship between anatomical accuracy and postoperative outcomes.
SAN DIEGO — Anatomic total shoulder arthroplasty and reverse shoulder arthroplasty may yield similar outcomes in patients with rotator cuff intact glenohumeral osteoarthritis, according to results presented here.
“We have reiterated the fact that an anatomic reconstruction for a total [shoulder] is important, but we do not know what that is or if it is important yet for a reverse,” Logan C. Kolakowski, MD, assistant professor of orthopedics in the University of Maryland Health System, said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Kolakowski, Michael Kucharik, MD, Mark A. Frankle, MD, and colleagues retrospectively reviewed data from 50 patients (26 men, 24 women) with primary rotator cuff intact glenohumeral OA who underwent primary anatomic TSA and contralateral primary RSA.
Logan C. Kolakowski
Variables measured included glenoid morphology, as well as patient-reported outcomes and range of motion at 3 to 6 months, 12 months, 24 months, final follow-up and revision surgery. Researchers also collected radiographic measurements to evaluate quality of reconstruction and changes in center of rotation for anatomic TSA and anatomic reverse center for RSA.
According to Frankle, chief of shoulder service at the Florida Orthopedic Institute, patients with anatomically accurate TSAs had favorable postoperative outcomes, while TSAs that were anatomically inaccurate did not.
However, Frankle said RSAs did not show any relationship between anatomical accuracy and postoperative outcomes.
“A reverse shoulder may be a more forgiving operation in terms of how accurate you are able to reduce the anatomy compared to a total, and that might help surgeons decide which they might feel more comfortable doing based upon their ability,” Frankle told Healio.
In addition, Frankle said there was no difference in clinical outcomes between TSA and RSA. He said the only difference between the two groups was internal rotation at the 2-year time point, which favored TSA, but ultimately evened out at final follow-up.
“If you are going to do an anatomic total shoulder, you have to have the technical ability and the implants available to get it anatomically close to normal,” Frankle said. “If you have a lower volume surgeon, it might be totally justified for those surgeons to do reverses because it does seem to be more forgiving in terms of how the operation is performed and getting a good outcome.”
For more information:
Mark A. Frankle, MD, wishes to be contacted through Kaitlyn Christmas at kchristmas@foreonline.org.
Sources/Disclosures
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Kucharik MP, et al. Paper 278. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.
Disclosures:
Frankle and Kolakowski report no relevant financial disclosures.