Anatomical Versus Reverse Total Shoulder Arthroplasty For Primary Glenohumeral Osteoarthritis With An Intact Rotator Cuff

Description

In this episode of AI Talks with Bone & Joint, hosts Brian and Lisa discuss a 2026 paper by Shah et al. comparing anatomical total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) for primary glenohumeral osteoarthritis in patients with an intact rotator cuff. They explain that the systematic review of 18 studies found anatomical TSA generally provides better postoperative range of motion, especially rotational motion, but both procedures have similar rates of pain relief, patient satisfaction, complications, and revision. Common complications differed somewhat between procedures: anatomical TSA more often involved glenoid loosening and rotator cuff injury, while RTSA more often involved infection, glenoid loosening, and periprosthetic fracture. The episode also notes a cost-utility analysis suggesting anatomical TSA may be more cost-effective around age 72, and highlights radiological findings that RTSA may have fewer radiolucent lines, potentially indicating better long-term implant stability. The hosts conclude that both procedures have distinct advantages and that the choice should be individualized based on patient characteristics, stiffness, and clinical scenario.

Specialties

Paper Links

https://boneandjoint.org.uk/Article/10.1302/2633-1462.78.BJO-2025-0297.R2