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 patients with 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 if they had preserved preoperative motion with a minimum of 2 years of follow-up, or until complication/revision. Shoulder ROM 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). Patients in the RSA group were significantly older at surgery (73.9 versus 65.1 years; P=0.003). Postoperatively, the mean change in active elevation was -15 degrees for HA versus 26 degrees for RSA, with RSA having significantly greater active elevation (153 degrees versus 123 degrees; 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.