Speed of recovery after shoulder arthroplasty: a comparison of reverse and anatomic total shoulder arthroplasty

Functional internal rotation after shoulder arthroplasty: a comparison of anatomic and reverse shoulder arthroplasty

“…Nonetheless, this subgroup analysis was purely observational as the study was not designed to detect differences related to subscapularis management. Improvements with respect to internal rotation after RSA have been limited, 10,22,23 with no significant observed changes in ADLs. 13 Minimal improvements of 3 to 5 vertebral levels, with a median postoperative internal rotation range of motion of T12 to L1, have been reported after RSA, 9,23 consistent with the findings of this study.…”

“…Internal rotation improvement has been shown to plateau at 1 year after TSA and at 2 years after RSA. 10 By including a minimum 2-year follow-up, this study was able to capture the final internal rotation typically observed postoperatively. In addition, attempts were made to control measurement bias by including patient's subjective assessments of internal rotation, which showed a moderate correlation with physician-measured internal rotation motion.…”

“…1). 10 Subjective internal rotation was assessed by allowing each patient to select the picture best representing the ability to place the hand to the highest midline segment of the back (Fig. 1).…”

“…1,19 Patients treated with RSA have demonstrated limited improvements in internal rotation. 10,22,23 This limitation has been the primary reason for some authors advocating against performing bilateral RSA because of a fear of complete loss of the ability to perform simple tasks like toileting. 26 Restoration of internal rotation after RSA may be less related to subscapularis function as Clark et al 3 reported no difference in internal rotation motion with and without subscapularis repair.…”

Expanding roles for reverse shoulder arthroplasty

“…While one comparative study suggested that RTSA may provide more improvement in AFE, strength, and functional outcome scores than TSA, in this study, these procedures were performed for different indications and thus these results may not be directly comparable [44] Other comparable studies suggest outcomes between TSA and RTSA to be similar, although RTSA consistently provides inferior rotational motion, particularly internal rotation [17,45,46]. Other authors have argued that in patients with pre-operative external rotation lag signs, post-operative active external rotation can be improved with the addition of a latissimus dorsi transfer [47].…”