PMID- 34292824
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1938-2367 (Electronic)
IS  - 0147-7447 (Linking)
VI  - 44
IP  - 4
DP  - 2021 Jul-Aug
TI  - The Comparative Effect of Age on Clinical Outcomes Following Anatomic Total 
      Shoulder Arthroplasty and Reverse Total Shoulder Arthroplasty.
PG  - e600-e606
LID - 10.3928/01477447-20210618-24 [doi]
AB  - 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<.01, respectively). In patients aged 75 years or older, the 
      percentages of patients achieving MCID were similar (93.1% TSA and 92.3% RTSA; 
      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.].
FAU - Shah, Sarav S
AU  - Shah SS
FAU - Fu, Michael C
AU  - Fu MC
FAU - Ling, Daphne
AU  - Ling D
FAU - Wong, Alexandra
AU  - Wong A
FAU - Warren, Russell F
AU  - Warren RF
FAU - Dines, David M
AU  - Dines DM
FAU - Dines, Joshua S
AU  - Dines JS
FAU - Gulotta, Lawrence V
AU  - Gulotta LV
FAU - Taylor, Samuel A
AU  - Taylor SA
LA  - eng
PT  - Journal Article
DEP - 20210701
PL  - United States
TA  - Orthopedics
JT  - Orthopedics
JID - 7806107
SB  - IM
MH  - Aged
MH  - *Arthroplasty, Replacement, Shoulder
MH  - Humans
MH  - *Osteoarthritis/surgery
MH  - Range of Motion, Articular
MH  - Retrospective Studies
MH  - *Shoulder Joint/surgery
MH  - Treatment Outcome
EDAT- 2021/07/23 06:00
MHDA- 2021/10/16 06:00
CRDT- 2021/07/22 17:17
PHST- 2021/07/22 17:17 [entrez]
PHST- 2021/07/23 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
AID - 10.3928/01477447-20210618-24 [doi]
PST - ppublish
SO  - Orthopedics. 2021 Jul-Aug;44(4):e600-e606. doi: 10.3928/01477447-20210618-24. 
      Epub 2021 Jul 1.