Key result
Reverse shoulder arthroplasty linked to ~31% higher 30-day readmission risk vs anatomic arthroplasty in patients ≥70.
Why the study?
Reverse total shoulder arthroplasty is increasingly used in elderly patients with glenohumeral osteoarthritis regardless of rotator cuff integrity, but readmission rates and utilization trends compared to anatomic total shoulder arthroplasty required clarification.
Does reverse total shoulder arthroplasty compared to anatomic total shoulder arthroplasty affect readmission rates in patients aged ≥70 with glenohumeral osteoarthritis?
Cohort (n=251,048)
Yes
Does reverse total shoulder arthroplasty compared to anatomic total shoulder arthroplasty affect readmission rates in patients aged ≥70 with glenohumeral osteoarthritis?
Odds Ratio: 1.314 (95% CI 1.245–1.387)
Absolute Event Rate: 3.5% vs 2.3%
p-value: p=< .001
In patients aged ≥70 with glenohumeral osteoarthritis, reverse total shoulder arthroplasty is associated with a higher risk of 30- and 90-day readmission compared to anatomic total shoulder arthroplasty, despite its increasing utilization.
May warrant caution selecting reverse over anatomic TSA in patients ≥70; leaves open randomized confirmation of readmission risk.
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.
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Joshi et al. (2025) conducted a cohort in Glenohumeral osteoarthritis (n=251,048). Reverse total shoulder arthroplasty (rTSA) vs. Anatomic total shoulder arthroplasty (aTSA) was evaluated on 30-day readmission (OR 1.314, 95% CI 1.245-1.387, p=< .001). Reverse total shoulder arthroplasty in patients ≥70 was associated with a higher 30-day readmission risk than anatomic arthroplasty (OR 1.314; 95% CI 1.245-1.387; P<.001).
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