Reverse Shoulder Arthroplasty Provides Durable Outcomes Regardless of Diagnosis and Pathology

Introduction As surgical indications for reverse shoulder arthroplasty (RSA) have expanded, appropriate patient counseling and shared decision-making should be informed by clinical outcomes specific to each indication for RSA. While RSA has traditionally been indicated in patients with rotator cuff arthropathy (RCA), it has been employed increasingly in patients with osteoarthritis and in intact rotator cuff with better-reported outcomes. To compare patient-reported outcomes (PROs) and postoperative range of motion (ROM) following RSA for patients with RCA compared to those with rotator cuff-intact glenohumeral OA. Methods All patients undergoing RSA from January 2016 to September 2021 by a single surgeon at a single institution were retrospectively identified through a prospectively collected database. Patients indicated for RSA secondary to OA without rotator cuff pathology were compared to patients indicated for RSA secondary to RCA. Patient-reported outcomes (PROs), including the Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), Shoulder Arthroplasty Smart (SAS) score, and University of California-Los Angeles (UCLA) scores, as well as active range of motion (ROM) were measured preoperatively and at a minimum 2-year follow-up, with outcomes between groups based on RSA indication compared. Results A total of 107 patients (n=71 RCA group, n=36 OA group) were identified, with no difference in patient demographics. No significant differences between groups were appreciated at the final follow-up based on SST (p = 0.765), ASES (p = 0.437), SAS (p=0.782), or UCLA (p = 0.313) scores, or ROM (all, p<0.622). One patient (2.8%) in the OA group underwent revision surgery due to dislocation, while one patient (1.4%) in the RCA group required revision due to an infection associated with the spacer. Conclusion Patients undergoing RSA for glenohumeral OA without rotator cuff pathology reported comparable patient reports outcomes and ROM values at a minimum 2-year follow-up compared to patients indicated for RSA secondary to RCA.