Retrospective, single-centre analysis comparing clinical outcomes of reverse total shoulder replacement for fracture, degenerative changes and revision procedure.

BACKGROUND: Reverse total shoulder arthroplasty (RTSA) is a widely used treatment for both traumatic and degenerative glenohumeral joint diseases. Despite its popularity, data on outcomes sorted according to indications have revealed inconsistent results. Furthermore, the clinical outcome is rarely analysed in a differentiated manner using several scores. This retrospective, single-center study aimed to investigate the impact of indications on the clinical outcomes of RTSA. METHODS: The Constant Score, EQ-5D-5L, DASH Score were sent by post to 263 patients who received a RTSA between February 2011 and March 2022. The follow-up period was 12-139 months. Patients were categorized into primary-fracture, secondary-intervention, and degenerative-disease groups based on the indications for RTSA. We have calculated the corresponding average scores for each group. RESULTS: Of the 263 patients included in the study, 136 completed the questionnaire. The mean follow-up duration was 48 months. All outcome measures were approximately normally distributed. The mean values were as follows. Constant Score: degenerative disease 58 ± 19, primary fracture 52 ± 18, secondary intervention 49 ± 18. DASH Score: degenerative disease 35 ± 20, primary fracture 40 ± 17, secondary intervention 42 ± 20. EQ-5D-5L Index: degenerative disease 0.72 ± 0.24, primary fracture 0.75 ± 0.20, secondary intervention 0.68 ± 0.39. CONCLUSIONS: In this study, clinical outcomes after RTSA varied according to the underlying indication, with the best results observed in patients with degenerative diseases and the lowest in patients undergoing secondary interventions. Further studies with larger, multi-centre cohorts are needed to confirm these findings and to strengthen the evidence base before clinical recommendations can be made. TRIAL REGISTRATION: 593/21ek.