TSA Versus RSA in Patients >75

Rothman Institute Orthopaedics

Status

Unknown

Conditions

Total Shoulder Arthoplasty

Treatments

Procedure: Reverse Total Shoulder Replacement

Procedure: Anatomic Total Shoulder Replacement

Study type

Interventional

Funder types

Other

Identifiers

NCT04827277

JABB20D.949

Details and patient eligibility

About

Total shoulder arthroplasty (TSA) has proven to be a predictable and successful operation for the treatment of symptomatic glenohumeral osteoarthritis (GHOA) with an intact rotator cuff. Results after TSA have not been as good in cases with rotator cuff dysfunction, however. Early glenoid loosening, shoulder pain and the need for revision surgery has been all associated with rotator cuff deficiency. Even in cases without tears, fatty infiltration of the rotator cuff has been associated with inferior outcomes in TSA.

Advanced age has been shown to be associated with increased fatty infiltration of the rotator cuff in shoulders with primary osteoarthritis. Because of this, one may propose that surgeons should avoid the potential complications with TSA and perform RSA for patients with advanced age. It is thus the purpose of this study to evaluate the patient reported outcomes (PROs) of total shoulder arthroplasty (TSA) compared with reverse shoulder arthroplasty (RSA) in patients >75 years of age

Enrollment

108 patients

Sex

All

Ages

75+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

All patients (75 years of age) at the time of surgery
Patient is willing to participate by complying with pre and postoperative visit requirements
Patient is willing to consent for enrollment
Patient has advanced imaging (CT or MRI) that demonstrates an intact rotator cuff

Exclusion criteria

Patients under the age of 75
Need for any structural graft for repair of the shoulder during surgery
Current infection of the proximal humerus or scapula
Proximal humerus fracture
Inadequate or malformed bone that precludes adequate support for prosthesis (B2, B3, C Glenoid morphology)
Neuromuscular disorder that does not allow control of the shoulder joint
Significant injury to the brachial plexus
Diagnosis of inflammatory arthropathy
Preoperative diagnosis of full thickness rotator cuff tear
>Goutallier Stage 1 rotator cuff atrophy
Prior shoulder arthroplasty
Non-functioning deltoid muscle
Patients who are known drug or alcohol abuser, or have a psychological disorder as defined by the DSM4 that could affect follow-up care
Patient is a prisoner
Patients who are currently involved in any personal injury litigation, or worker's compensation claims.