Bilateral Anatomic Total Shoulder Arthroplasty Versus Reverse Shoulder Arthroplasty

• Published in: Orthopedics (Thorofare, N.J.) Vol. 35; no. 4; pp. e479 - e485
• Main Authors: Latif, Vaqar, Denard, Patrick J, Young, Allan A, Liotard, Jean-Pierre, Walch, Gllies
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01.04.2012
• Subjects: Adult; Aged; Arthroplasty - methods; Female; Humans; Joint Instability - diagnosis; Joint Instability - surgery; Joint replacement surgery; Male; Middle Aged; Necrosis; Osteoarthritis; Osteoarthritis - diagnosis; Osteoarthritis - surgery; Patient satisfaction; Polyethylene; Prostheses; Range of Motion, Articular; Rehabilitation; Retrospective Studies; Rheumatoid arthritis; Rotator cuff; Shoulder; Shoulder Joint - surgery; Treatment Outcome; France
• ISSN: 0147-7447; 1938-2367
• DOI: 10.3928/01477447-20120327-25

The results of anatomic total shoulder arthroplasty and reverse shoulder arthroplasty have previously been reported separately. Although the indications differ, scenarios exist in which a patient may have a total shoulder arthroplasty on 1 shoulder and a reverse shoulder arthroplasty on the contralateral shoulder. Between 1992 and 2009, twelve patients underwent bilateral sequential primary shoulder arthroplasty with a total shoulder arthroplasty on 1 side and reverse shoulder arthroplasty on the contralateral side. Constant score, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value, and patient satisfaction were obtained a minimum 1 year postoperatively. Mean postoperative Constant score was 77 after total shoulder arthroplasty and 73 after reverse shoulder arthroplasty (Between 1992 and 2009, twelve patients underwent bilateral sequential primary shoulder arthroplasty with a total shoulder arthroplasty on 1 side and reverse shoulder arthroplasty on the contralateral side. Constant score, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value, and patient satisfaction were obtained a minimum 1 year postoperatively. Mean postoperative Constant score was 77 after total shoulder arthroplasty and 73 after reverse shoulder arthroplasty ( P <.2488). Mean postoperative active forward flexion was similar after total shoulder arthroplasty compared with reverse shoulder arthroplasty ( P =.8910). Greater external rotation at the side (43° vs 12°; P <.0001) and internal rotation (T8 vs L1; P <.0001) were observed after total shoulder arthroplasty. Mean ASES score was 89.6 after total shoulder arthroplasty compared with 82.4 after reverse shoulder arthroplasty ( P =.0125). Patient satisfaction was 92% for both prostheses, and mean subjective shoulder value was similar (85.4% vs 82.5%; P =.6333). Bilateral shoulder arthroplasty performed with a total shoulder arthroplasty and reverse shoulder arthroplasty on opposite shoulders can provide good functional outcome and high patient satisfaction. Although range of motion is better following total shoulder arthroplasty, no difference was observed in final Constant score or subjective patient assessment.