Outcomes of reverse vs anatomic total shoulder arthroplasty in glenohumeral osteoarthritis without rotator cuff deficiency: A meta-analysis

Table 1 Summary of included studies comparing reverse total shoulder arthroplasty and total shoulder arthroplasty

Ref.	Study	Participants		Age (years)		Mean follow-up		Glenoid morphology		Adverse events
		RTSA	TSA	RTSA	TSA	RTSA	TSA	RTSA	TSA	RTSA	TSA
Ardebol et al[14], 2024	Retrospective	37	67	80	79	33 months	43 months	8 A14 A22 B123 B2/B3	28 A13 A221 B115 B2/B3	1 stiffness 1 acromial stress fracture	3 rotator cuff failure 2 stiffness
Haritinian et al[15], 2020	Retrospective	12	39	71	68	-		3 A11 A22 B16B2/B3	13 A16 A213 B17 B2/B3	-	-
Hones et al[16], 2024	Retrospective	60	60	72	70	3.7 years	4.0 years	-		-	-
Kim[17], 2024	Retrospective	26	41	75	76	45 months	39 months	16A15A24B11B2	31 A17A21B12B2	1 infection	1 rotator cuff tear with glenoid loosening
Kirsch et al[18], 2022	Retrospective	67	67	67		27 months	33 months	17 A17A24 B134 B2/B33C2D	25 A11A23B134B2/B33C1D	1 acromial stress fracture 1 glenoid fracture 1 radial nerve palsy	1 rotator cuff tear, 1 ulnar nerve palsy 1 hematoma
Mahylis et al[19], 2024	Retrospective	149	187	71	66	41 months	62 months	-		1 glenoid loosening	11 glenoid loosening 3 nonspecified
Merolla et al[20], 2020	Retrospective	36	47	72		2.4 years		-		2 diaphyseal fractures	1 rotator cuff tear
Polisetty et al[21], 2021	Retrospective	63	252	74	73	3.8 years		2A17A22B137B2/B32C13D	81 A147A214 B197B2/31C12D	-	5 rotator cuff tears (with 2 glenoid loosening) 1 infection with glenoid loosening 5 glenoid loosening
Steen et al[22], 2015	Retrospective	24	96	78	77	3.5 years		7A15A21B18B23C	28A120A24B132B212C	1 periprosthetic fracture	5 glenoid loosening
Trammell et al[23], 2023	Retrospective	64	64	72	68	3 years	5 years	-		1 component failure 1 glenoid fracture 2 periprosthetic fractures 2 intraoperative fractures	4 glenoid loosening 1 humeral loosening 1 humeral and glenoid loosening 1 component failure 3 infections 1 periprosthetic fracture 2 unexplained pain
Turnbull et al[24], 2024	Retrospective	9	46	71	67	-		-		1 glenoid fracture	6 glenoid loosening 2 component failures 1 glenoid and humeral loosening 1 infection1 glenoid fracture 1 periprosthetic fracture 1 unexplained pain
Wright et al[25], 2020	Retrospective	33	102	77		6 years		-		1 infection 1 fracture 1 nerve palsy 1 vascular injury	11 rotator cuff tears 2 fractures 1 recurrent dislocation

RTSA: Reverse total shoulder arthroplasty; TSA: Total shoulder arthroplasty.

Table 2 Distribution of preoperative glenoid morphology according to the Walch classification among patients receiving reverse total shoulder arthroplasty and total shoulder arthroplasty

Walch type	RTSA (n = 381)	TSA (n = 507)
Type A1	53	206
Type A2	29	84
Type B1	15	66
Type B2/B3	108	175
Type C	8	16
Type D	15	13

RTSA: Reverse total shoulder arthroplasty; TSA: Total shoulder arthroplasty.

Table 3 Risk of bias assessment for included studies using the Risk of Bias in Non-randomized Studies of Interventions tool

Ref.	Bias due to confounding	Bias in selection of participants	Bias in classification of interventions	Bias due to deviations from intended interventions	Bias due to missing data	Bias in measurement of outcomes	Bias in selection of reported result	Overall risk of bias
Ardebol et al[14], 2024	Moderate	Low	Low	Low	Low	Low	Low	Low
Haritinian et al[15], 2020	Moderate	Moderate	Low	Low	Low	Moderate	Low	Moderate
Hones et al[16], 2024	Moderate	Low	Low	Low	Low	Low	Low	Low
Kim[17], 2024	Moderate	Low	Low	Low	Low	Low	Low	Low
Kirsch et al[18], 2022	Moderate	Low	Low	Low	Low	Moderate	Low	Moderate
Mahylis et al[19], 2024	Serious	Moderate	Low	Low	Low	Moderate	Moderate	Serious
Merolla et al[20], 2020	Serious	Moderate	Moderate	Low	Moderate	Moderate	Low	Serious
Polisetty et al[21], 2021	Moderate	Low	Low	Low	Low	Low	Low	Low
Steen et al[22], 2015	Moderate	Low	Low	Low	Low	Low	Low	Low
Trammell et al[23], 2023	Moderate	Low	Low	Low	Moderate	Moderate	Moderate	Moderate
Turnbull et al[24], 2024	Moderate	Low	Moderate	Low	Moderate	Moderate	Low	Moderate
Wright et al[25], 2020	Serious	Low	Low	Low	Moderate	Moderate	Moderate	Serious

Low: Comparable to a well-performed randomized trial; Moderate: Sound for a non-randomized study but not comparable to a high-quality randomised control trial; Serious: Important problems in design or execution.

Table 4 Summary of reported complications for reverse total shoulder arthroplasty and total shoulder arthroplasty cohorts

Complication	RTSA	%	TSA	%
Glenoid-related
Glenoid fracture	3	0.5%	1	0.1%
Glenoid loosening	1	0.2%	37	3.6%
Dislocation	-	-	1	0.1%
Humeral-related
Humeral loosening	-	0.0%	3	0.3%
Diaphyseal fracture	3	0.5%	-	-
Periprosthetic fracture	3	0.5%	2	0.2%
Unspecified fractures	-	-	2	0.2%
Intraoperative fractures	2	0.3%	-	-
Rotator cuff/soft tissue
Rotator cuff tear/failure	-	-	22	2.1%
Acromial stress fracture	2	0.3%	-	-
Stiffness	1	0.2%	2	0.2%
Neurologic/vascular
Nerve palsy	2	0.3%	1	0.1%
Vascular injury	1	0.2%	1	0.1%
Infectious
Infection	1	0.2%	5	0.5%
PJI	3	0.5%	3	0.3%
Hematoma	-	-	1	0.1%
Implant-related
Component failure	1	0.2%	3	0.3%
Broken baseplate screw	1	0.2%	-	-
Other/unexplained
Unexplained pain	1	0.2%	3	0.3%
Total complications	28	4.8%	103	10.0%

RTSA: Reverse total shoulder arthroplasty; TSA: Total shoulder arthroplasty; PJI: Prosthetic joint infection.