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Primary inlay reverse shoulder arthroplasty has a higher rate of revision than onlay reverse shoulder arthroplasty: Analysis from the Australian Orthopaedic Association National Joint Replacement Registry

Version 2 2024-05-31, 03:18
Version 1 2023-02-09, 22:16
journal contribution
posted on 2024-05-31, 03:18 authored by DRJ Gill, Stephen GillStephen Gill, S Corfield, C Holder, Richard PageRichard Page
Background Two classes of primary reverse total shoulder arthroplasty (rTSA), inlay (in-rTSA), and onlay (on-rTSA) were compared to determine differences in rates of revision. Methods Between 1 January 2012 and 31 December 2020, all primary in-rTSA or on-rTSA procedures were compared from a large national arthroplasty registry by cumulative percentage revision (CPR). Kaplan–Meier estimates of survivorship and hazard ratios from Cox proportional hazard models adjusted for age, gender, glenosphere size, and humeral fixation determined any associations to the risk of revision. Results Of the 14,807 in-rTSA and 6590 on-rTSA procedures, the CPR at seven years was 4.9%. There was an increased risk of revision for in-rTSA vs on-rTSA ( p = 0.039) when adjusted for age, gender, glenosphere size, and humeral fixation. Glenosphere size <38 mm adjusted for age and gender ( p = 0.016) increased the revision risk. Revision for instability/dislocation occurred more often for in-rTSA vs on-rTSA ( p < 0.001) in the first three months. Males had a higher rate of revision than females for in-rTSA (3months+, p = 0.001) and for on-rTSA ( p < 0.001). Discussion Care should be taken when considering in-rTSA particularly in males, and if preoperative planning suggests a small (<38 mm) glenosphere. Level of evidence Level III, therapeutic study. Original article.

History

Journal

Shoulder and Elbow

Volume

15

Pagination

75-81

ISSN

1758-5732

eISSN

1758-5740

Language

en

Publication classification

C1 Refereed article in a scholarly journal

Issue

3 supplement

Publisher

SAGE Publications

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