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Should patients over 70 years of age have anatomic or reverse total shoulders for their osteoarthritis?

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Should patients over 70 years of age have anatomic or reverse total shoulders for their osteoarthritis?


           




According to yesterday’s blog (click here), the failure of the rotator can cause problems after anatomical total shoulder arthroplasty. This did not result in a higher revision rate compared to patients with intact cuffs and arthritis who underwent reverse total shoulder arthroplasty (RSA). Some surgeons might use RSA on older patients because the risk of cuff rupture increases with age.

The authors of Similar rates of revision surgery following primary anatomic compared to reverse shoulder arthroplasty in patients ≥70 years old with glenohumeral osteoarthritis: A cohort study of 3,791 patients, sought to determine whether RSA was associated with lower rates of revision surgery in comparison to TSA for patients with arthritis and an intact cuff aged 70 and above. The average age was 75.8 and 43.4% of patients were male.

TSA was performed more often for these patients, 685 RSA compared to 3,106 TSA. Follow-up completion was excellent for the entire cohort: 97.1%. (97.7% RSA and 97.0% TSA).

The cumulative revision probabilities at 5 years follow-up were 2.4% and 3.4% respectively for RTSA (Thyroid Suppression) and TSA (Retinol Steroid Absorption). No significant differences were found in the revision risk or 90 day emergency room visit after accounting for…



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