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A new study has provided valuable insights into the ongoing debate surrounding two types of shoulder replacement surgery: reverse total shoulder replacement and anatomical total shoulder replacement as a treatment for patients with osteoarthritis.

Anatomical and reverse total shoulder replacements
Anatomical total shoulder replacement (TSR): a prosthetic ball and socket replacement that matches the normal ball and socket anatomy of the shoulder joint (left). Reverse total shoulder replacement (RTSR): a prosthetic ball and socket replacement that reverses the normal ball and socket anatomy of the shoulder joint (right).

The study, published in the British Medical Journal (BMJ), and funded by the National Institute for Health and Care Research (NIHR), has found that reverse total shoulder replacements (RTSR) provide similar long-term outcomes to traditional anatomical total shoulder replacements (TSR) for patients aged 60 years or older with osteoarthritis (OA) and intact rotator cuff tendons.

Shoulder OA is a common and debilitating condition, and shoulder replacement surgery is an effective treatment option for end-stage disease. TSR has long been considered the gold standard for treating patients with OA and intact rotator cuff tendons. However, the RTSR has surged in popularity since 2008 in the UK. Originally designed for a completely different surgical indication, it is now often used instead of TSR in this patient group.

This shift in practice is growing despite a lack of supporting evidence, and in 2020, the National Institute for Health and Care Excellence (NICE) identified this as a key research priority. Researchers from NDORMS, University of Oxford, set out to provide high-quality evidence to help address this uncertainty.

Read the full story on the Nuffield Department of Orthopaedics and Musculoskeletal Sciences.