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Is there evidence that the outcomes of primary anatomic and reverse shoulder arthroplasty are getting better?

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Abstract

Purpose

Have the results of shoulder arthroplasty got better over the last two decades? To answer this question, we sought published evidence that the patient-reported outcomes and re-operation rates have improved in reports of more recently performed anatomic (TSA) and reverse (RSA) total shoulder arthroplasties.

Methods

We analyzed the arthroplasty results among studies published from 1990 to 2015, adjusting for the fact that the different publications presented patient groups with different combinations of diagnoses, used various outcome scales, and had different lengths of follow-up.

Results

The adjusted clinical outcomes (p = 0.048), but not the revision rates (p = 0.3), were significantly better for articles reporting more recent TSA procedures. Neither the clinical outcomes (p = 0.9) nor the revision rates (p = 0.4) were significantly better in articles reporting more recent RSA surgeries.

Conclusions

Better evidence from reports with greater detail will be necessary to show that patients are realizing progressively better outcomes from shoulder arthroplasty.

Level of evidence

Level IV

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Author information

Authors and Affiliations

  1. The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA

    Jeremy S. Somerson

  2. The Mountain-Whisper-Light Statistics, 1827 23rd Avenue East, Seattle, WA, 98112, USA

    Moni B. Neradilek

  3. Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Box 356500, Seattle, WA, 98195-6500, USA

    Jason E. Hsu, Albert O. Gee & Frederick A. Matsen III

  4. Orthopaedic Surgery and Sports Medicine, Orlando Health, 1222 S. Orange Ave., 5th floor, Orlando, FL, 32806, USA

    Benjamin C. Service

Authors
  1. Jeremy S. Somerson
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  2. Moni B. Neradilek
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  3. Jason E. Hsu
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  4. Benjamin C. Service
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  5. Albert O. Gee
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  6. Frederick A. Matsen III
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Corresponding author

Correspondence to Frederick A. Matsen III.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent was not required.

Funding

There was no extramural funding for this investigation.

Conflict of interest

Outside of this submitted work, Dr. F.A. Matsen has received royalties from the Elsevier Publishing Company for The Shoulder, 4th edition by C.A. Rockwood Jr and F.A. Matsen III; Dr. J.S. Somerson is receiving direct payment from Springer Publishers through a consulting agreement. The other four authors declare that they have no conflicts of interest.

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Somerson, J.S., Neradilek, M.B., Hsu, J.E. et al. Is there evidence that the outcomes of primary anatomic and reverse shoulder arthroplasty are getting better?. International Orthopaedics (SICOT) 41, 1235–1244 (2017). https://doi.org/10.1007/s00264-017-3443-0

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  • DOI: https://doi.org/10.1007/s00264-017-3443-0

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