Clinical and functional outcomes of reverse total shoulder arthroplasty for proximal humerus fracture versus rotator cuff arthropathy: A retrospective analysis

Introduction

The utility of reverse total shoulder arthroplasty (RTSA) has evolved to accommodate many complex shoulder pathologies including proximal humerus fractures (PHFs) and fracture sequelae. Within our aging population, PHFs are occurring at higher rates than ever before. Literature assessing differences in clinical and functional following RTSA for PHF and rotator cuff arthropathy (RCA) is limited. This study aims examine outcomes after RTSA for PHF and RCA at 2-years follow-up.

Methods

Records of who underwent RTSA for PHF and RCA at our institution between July 1, 2009 to October 1, 2019 with a 2-year minimum follow-up were retrospectively analyzed. Patient demographic information, postoperative functional measurements, and complications were collected. A 5-year Kaplan-Meier survival analysis was performed.

Results

Overall, 23 patients underwent RTSA for fracture and 123 for RCA. Fracture patients showed significantly worse forward elevation (128.9° ± 38.8° vs 141.9° ± 21.1°; p-value = 0.0242). No differences were observed in range of motion or strength for external rotation and internal rotation, as well as patient-reported outcome measures. Fracture patients showed a complication rate of 9.1 % and an implant survival rate of 78.0 % after 5 years. RCA patients experienced a 7.4 % complication rate and a 91.5 % survival rate after 5 years.

Discussion

RTSA has been shown to restore shoulder functionality in patients with complex PHFs. In this study, RTSA for fracture resulted in similar functionality, complication rates, and implant longevity when compared to elective indications.