Functional outcome of hemiarthroplasty compared with reverse total shoulder arthroplasty in the treatment of rotator cuff tear arthropathy

Background: Hemiarthroplasty was the treatment of choice for rotator cuff tear arthropathy (CTA) before the introduction of the reverse total shoulder arthroplasty (RTSA). The purpose of this study was to compare our outcomes for hemiarthroplasty with those for RTSA. Methods: The records of patients with the diagnosis of CTA who had received either a hemiarthroplasty or RTSA from 1997 to 2007 were reviewed. A minimum of 2 years' follow-up was required. Active shoulder elevation, external rotation, internal rotation, and Shoulder Pain and Disability Index (SPADI) scores were obtained. Statistical analysis was performed comparing function, pain, and range of motion of hemiarthroplasty patients with RTSA patients. Results: We identified 56 shoulder arthroplasties in 50 patients with a minimum of 2 years' follow-up. There were 20 hemiarthroplasties and 36 RTSAs performed. The mean follow-up was 4.4 years (range, 2-12 years) in the hemiarthroplasty group and 3 years (range, 2-5 years) in the RTSA group. The mean age in the hemiarthroplasty group was 64 years versus 72 years in the RTSA group (P < .05). SPADI scores improved in both groups. However, after follow-up of 2 years or greater, the mean SPADI scores were significantly better (lower) in the RTSA group (34) than in the hemiarthroplasty group (58) (P = .005). Active elevation was significantly better in the RTSA group at all postoperative time periods. The complication rate for both groups was 25%. Conclusions: RTSA performs better than hemiarthroplasty in terms of pain relief, function, and active elevation at 2-year follow-up. Level of evidence: Level III, Retrospective Case-Control Series, Treatment Study. (C) 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.