Reverse Shoulder Arthroplasty is Superior to Hemiarthroplasty for Cuff Tear Arthropathy with Preserved Motion

Background: It is unclear whether hemiarthroplasty (HA) or reverse shoulder arthroplasty (RS) are superior for patientswith cuff tear arthropathy (CTA) and preserved preoperative motion (elevation >90˚).Methods: This was a retrospective, single institution study. Patients who underwent RSA or HA for CTA were included ifthey had preserved preoperative motion with a minimum of 2 years of follow-up, or until complication/revision. ShoulderROM and functional outcomes scores were obtained.Results: Twenty-six HAs and 21 RSAs were evaluated at mean of 38.6 months (HA) and 36.3 months (RSA). Patientsin the RSA group were significantly older at surgery (73.9 versus 65.1 years; P=0.003). Postoperatively, the meanchange in active elevation was -15° for HA versus 26° for RSA, with RSA having significantly greater active elevation(153° versus 123°; P=0.01). There were no significant differences in final internal or external rotation between groups.Superior outcomes were seen for RSA versus HA for ASES score (84 vs. 66, P=0.003), Simple Shoulder Test (8.8 vs.7.3, P=0.3), Single Assessment Numeric Evaluation (85 vs. 70, P=0.017), and 100mm VAS pain (7 vs. 33, P<0.001).Conclusion: In patients with CTA and preserved preoperative forward elevation, RSA provided greater pain relief,superior functional outcomes, and better ROM compared with HA.Level of evidence: IV