Exactech Equinoxe anatomic versus reverse total shoulder arthroplasty for primary osteoarthritis: case controlled comparisons using the machine learning–derived Shoulder Arthroplasty Smart score

The role of reverse total shoulder arthroplasty (rTSA) for glenohumeral osteoarthritis (GHOA) with an intact rotator cuff remains unclear with prior investigations demonstrating similar patient-reported outcome measures (PROMs) to anatomic total shoulder arthroplasty (aTSA). However, legacy PROMs ar...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2023-04, Vol.32 (4), p.793-802
Main Authors: Marigi, Erick M., Hao, Kevin A., Friedman, Richard J., Greene, Alexander T., Roche, Christopher P., Wright, Thomas W., King, Joseph J., Schoch, Bradley S.
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Shoulder - methods
Case-Control Studies
ceiling effect
Clinical outcomes
Female
glenoid loosening
Humans
Machine Learning
Male
Middle Aged
Osteoarthritis - surgery
outcome score
Patient Reported Outcome Measures
Range of Motion, Articular
Retrospective Studies
reverse shoulder arthroplasty
rotator cuff
Shoulder Joint - surgery
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Summary:The role of reverse total shoulder arthroplasty (rTSA) for glenohumeral osteoarthritis (GHOA) with an intact rotator cuff remains unclear with prior investigations demonstrating similar patient-reported outcome measures (PROMs) to anatomic total shoulder arthroplasty (aTSA). However, legacy PROMs are subject to skewed distributions with many patients achieving the maximum possible score (ceiling scores). We evaluated a cohort of primary rTSAs performed for GHOA with an intact rotator cuff compared with a case-matched cohort of aTSAs using the Shoulder Arthroplasty Smart (SAS) score, a machine learning–derived outcome measure that eliminates the ceiling effect. A retrospective review of an international shoulder arthroplasty database was performed between 2001 and 2020. Patients undergoing rTSA for rotator cuff intact GHOA (n = 367) were matched 1:1 with aTSA controls (n = 367) with a minimum of 2-year follow-up. Assessed variables included patient demographics, range of motion, American Shoulder Elbow Surgeons score (ASES), Constant score, Simple Shoulder Test (SST), and the SAS score. Preoperatively, the SAS (49.0 vs. 45.2; P 
ISSN:1058-2746
1532-6500
1532-6500
DOI:10.1016/j.jse.2022.09.029