Clin Orthop Surg.  2019 Sep;11(3):316-324. 10.4055/cios.2019.11.3.316.

Outcomes of Bilateral Shoulder Arthroplasties: A Comparison of Bilateral Total Shoulder Arthroplasties and Bilateral Reverse Shoulder Arthroplasties

• Cox RM
• Brolin TJ
• Padegimas
• Lazarus MD
• Getz CL
• Ramsey ML
• Williams G
• Abboud JA

• KMID: 2462561
• DOI: http://doi.org/10.4055/cios.2019.11.3.316

Abstract

BACKGROUND
The purpose of this study was to compare outcomes of patients who underwent bilateral total shoulder arthroplasties (TSAs) for osteoarthritis (OA) versus bilateral reverse shoulder arthroplasties (RSAs) for cuff tear arthropathy (CTA).
METHODS
Inclusion criteria were patients who underwent bilateral TSAs for OA or bilateral RSAs for CTA with at least 2 years of follow-up. Twenty-six TSA patients (52 shoulders) were matched 2 to 1 with 13 RSA patients (26 shoulders) by sex, age at first surgery, and time between surgeries. Outcomes measured were shoulder range of motion (ROM), complications, and patient-reported scores.
RESULTS
Preoperatively, TSA patients had significantly better forward elevation (FE) of both shoulders than RSA patients (dominant side [Dom]: 103°± 32° vs. 81°± 31°, p = 0.047; nondominant side [non-Dom]: 111°± 28° vs. 70°± 42°, p = 0.005) without significant differences in external (ER) or internal rotation (IR). Postoperatively, TSA patients had significantly better FE (Dom and non-Dom: 156°± 12°, 156°± 14° vs. 134°± 24°, 137°± 23°; p = 0.006, p = 0.019) and ER (42°± 11°, 43°± 10° vs. 24°± 12°, 25°± 10°; p < 0.001, p < 0.001) bilaterally and IR of their dominant arm (L1 vs. L4, p = 0.045). TSA patients had significantly better activities of daily living external and internal rotations (ADLEIR) scores (Dom and non-Dom: 35.3 ± 1.0, 35.5 ± 0.9 vs. 32.1 ± 2.4, 32.5 ± 2.2; p = 0.001, p = 0.001), American Shoulder and Elbow Surgeons scores (94.2 ± 8.4, 94.2 ± 8.2 vs. 84.7 ± 10.0, 84.5 ± 8.0; p = 0.015, p = 0.004), and Single Assessment Numerical Evaluation (SANE) scores (93.5 ± 7.6, 93.8 ± 11.8 vs. 80.5 ± 14.2, 82.3 ± 13.1; p = 0.014, p = 0.025), with no significant difference in visual analog scale pain scores (0.4 ± 1.0, 0.3 ± 1.0 vs. 0.7 ± 1.3, 0.8 ± 1.2) bilaterally.
CONCLUSIONS
Overall, patients with bilateral TSAs and RSAs exhibited improved ROM and patient-reported outcomes. Those with bilateral TSAs had better functional outcomes than those with bilateral RSAs.

Keyword

Total shoulder arthroplasty; Total shoulder replacements; Osteoarthritis; Cuff tear arthropathy; Activities of daily living

MeSH Terms

Activities of Daily Living
Arm
Arthroplasty*
Elbow
Follow-Up Studies
Humans
Osteoarthritis
Range of Motion, Articular
Shoulder*
Surgeons
Tears
Visual Analog Scale

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