Reverse or anatomic shoulder arthroplasty for glenohumeral osteoarthritis in patients over 70: readmission rates and utilization trends

Abstract

Background

Reverse total shoulder arthroplasty (rTSA) is increasingly used to treat elderly patients with primary glenohumeral osteoarthritis regardless of rotator cuff integrity to avoid potential future revision surgery. We aimed to determine whether there was a difference in readmission rates and profile of patients aged ≥70 who underwent rTSA vs. anatomic total shoulder arthroplasty (aTSA) for GHOA and analyze a trend in the utilization of each arthroplasty type.

Methods

Nationwide Readmissions Database was queried to identify all patients aged ≥70 undergoing either rTSA or aTSA for GHOA from 2016 to 2021. The patients were then tracked to identify subsequent readmissions within 30 and 90 days. Patient demographics, readmission rates, and causes of readmission were analyzed.

Results

84,463 (33.6%) aTSA and 166,585 (66.4%) rTSA patients were identified utilizing weighted data. Of all patients undergoing aTSA, 2.3% and 2.1% were readmitted at 30 and 90 days, respectively. Of rTSA patients, 3.5% and 3.0% were readmitted at 30 and 90 days, respectively. At 30 and 90 days, patients undergoing rTSA were 1.314 (95% CI: 1.245-1.387; P < .001) and 1.223 (95% CI: 1.156-1.294; P < .001) times more likely to be readmitted than patients who underwent aTSA. From 2016 to 2021, there was a significant increase in utilization of rTSA for GHOA, with a 3.8% increase in utilization per year.

Conclusion

Patients ≥70 undergoing rTSA for GHOA have a higher risk of readmission at both 30 and 90 days. There continues to be a significant increase in the utilization of rTSA for GHOA at a rate of 3.8% per year.