• BACKGROUD
    • This study aimed to compare the outcomes of reverse total shoulder arthroplasty (rTSA) and anatomic total shoulder arthroplasty (aTSA) in patients with rotator cuff-intact osteoarthritis, assessing revision and complication rates, patient-reported outcomes, and postoperative range of motion.
  • METHODS
    • This systematic review and meta-analysis included comparative studies with levels I-III evidence that assessed rTSA and aTSA in patients with rotator cuff-intact osteoarthritis. Inclusion criteria required studies to report postoperative revision rates, complication rates, patient-reported outcomes, or range of motion with a minimum follow-up of 2 years. Studies focusing on noncomparative designs, biomechanical analyses, or case series were excluded. A comprehensive search of PubMed, Ovid Medline, and Scopus databases was conducted from their inception through December 2024. Odds ratios (ORs) with 95% CI were used for dichotomous outcomes, and mean differences (MDs) with 95% CI were used for continuous outcomes.
  • RESULTS
    • A total of 14 studies, encompassing 4,819 cases, were included in the analysis. rTSA demonstrated a significantly lower revision rate compared to aTSA (OR, 0.43; 95% CI, 0.29 to 0.65; p < 0.001), while both procedures yielded similar Constant scores (MD, -2.23; 95% CI, -5.80 to 1.33; p = 0.22), simple shoulder test (MD, 0.11; 95% CI, -0.30 to 0.52; p = 0.59), American Shoulder and Elbow Surgeons scores (MD, -1.51; 95% CI, -4.91 to 1.90; p = 0.39), subjective shoulder values (MD, 2.16; 95% CI, -2.44 to 6.75; p = 0.36), visual analog scale for pain (MD, -0.25; 95% CI, -0.72 to 0.21; p = 0.29), and ranges of motion, except for external rotation, where aTSA demonstrated superiority (MD, -11.28; 95% CI, -14.95 to -7.61; p < 0.001).
  • CONCLUSIONS
    • In patients with rotator cuff-intact osteoarthritis, rTSA is associated with a lower revision rate compared to aTSA, while achieving comparable clinical outcomes and range of motion, with the exception of external rotation.