The Comparative Effect of Age on Clinical Outcomes Following Anatomic Total Shoulder Arthroplasty and Reverse Total Shoulder Arthroplasty
| Autor: | David M. Dines, Joshua S. Dines, Russell F. Warren, Alexandra C. Wong, Daphne I Ling, Samuel A. Taylor, Sarav S. Shah, Michael C. Fu, Lawrence V. Gulotta |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Shoulder Joint business.industry Minimal clinically important difference medicine.medical_treatment Elbow Arthroplasty Surgery Treatment Outcome Patient satisfaction medicine.anatomical_structure Glenohumeral osteoarthritis Arthroplasty Replacement Shoulder Osteoarthritis Orthopedic surgery Humans Medicine Orthopedics and Sports Medicine In patient Rotator cuff Range of Motion Articular business Aged Retrospective Studies |
| Zdroj: | Orthopedics. 44 |
| ISSN: | 1938-2367 0147-7447 |
| DOI: | 10.3928/01477447-20210618-24 |
| Popis: | At many institutions, the pendulum has swung toward reverse total shoulder arthroplasty (RTSA). Good results have been reported for patients older than 65 years with glenohumeral osteoarthritis with an intact rotator cuff, leading to questioning of the role of anatomic total shoulder arthroplasty (TSA) in the elderly. The purpose of this study was to compare outcome measures between TSA and RTSA patients using minimal clinically important difference (MCID) and substantial clinical benefit (SCB) as a function of age. Primary TSA or RTSA patients with American Shoulder and Elbow Surgeons (ASES) scores at 2-year follow-up were retrospectively identified from a prospective database. Patients with a diagnosis of inflammatory arthritis, infection, proximal humerus fracture, or revision TSA were excluded. Patients were stratified by age as younger than 65 years, 65 to 74 years, and 75 years or older. A total of 659 TSA and 172 RTSA patients were included. Total shoulder arthroplasty had a larger improvement in ASES scores compared with RTSA in patients aged 65 to 74 years and 75 years and older ( P =.04 and P P =.53); however, a higher percentage of TSA patients achieved SCB vs RTSA patients (90.5% vs 76.9%; P =.01). This study highlights the importance of indications and a shared decision-making model to ensure patient satisfaction. The results support a trend that primary RTSA is a viable option for low-demand patients aged 75 years or older; however, appropriately indicated TSA offers a potential for greater improvement in ASES scores and is more successful at achieving SCB compared with RTSA at 2-year follow-up. [ Orthopedics . 2021;44(4):e600–e606.] |
| Databáze: | OpenAIRE |
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