Comparison of Survivorship and Failure Modes Between Anatomic and Reverse Total Shoulder Arthroplasty Across Multiple Government Joint Registries for a Single Platform Shoulder System

ABSTRACT

[...]recent years have seen a dramatic shift in utilization of rTSA in which rTSA is increasingly used to treat OA in patients with an intact rotator cuff, with a corresponding decline in use of aTSA.1-5 The reasons for this shift in usage are multi-factorial but may be due to the perceived lower risk of revision surgery with rTSA relative to aTSA, as the quality of the rotator cuff muscles and tendon are not necessary for a functional rTSA but are pre-requisite for a functional aTSA. Furthermore, these registries have high rates of government-mandated compliance such that all patients are enrolled and very few patients are lost to follow-up, thus minimizing the potential for selection bias that is inherently present in nearly all nongovernment registry clinical outcome studies. [...]to better understand the relative differences in primary aTSA and primary rTSA usage and performance, we analyzed two different government joint registries for survivorship and for reasons for revision associated with one platform shoulder system and compared trends in usage of aTSA and rTSA over a period of over 10 years to elucidate reasons for any market trends. Additionally, reasons for revision and the cumulative revision rate were assessed across the government joint registries to quantify and compare the performance of this platform shoulder prosthesis for primary aTSA and primary rTSA in each country over the study period. Over the period of analysis, use of primary aTSA and primary rTSA with the particular platform system has increased year to year in both Australia and the UK, with the exception of a decline in 2020 and 2021 due to COVID-19.