Anatomic Total Shoulder Arthroplasty Versus Reverse Total Shoulder Arthroplasty for Post-Capsulorrhaphy Arthropathy.

Post-capsulorrhaphy arthropathy is a long-term sequela that can develop after open anterior stabilization surgeries, which have historically been performed. The purpose of this study was to compare anatomic total shoulder arthroplasty (ATSA) with reverse total shoulder arthroplasty (RTSA) for the treatment of post-capsulorrhaphy arthropathy. There were 19 patients in the ATSA cohort and 20 in the RTSA cohort. All patients included had a minimum of 2 years of follow-up (ATSA mean, 59.5 months; RTSA mean, 43.8 months). Patients were followed clinically (American Shoulder and Elbow Surgeons score, Simple Shoulder Test score, range of motion analysis, and patient satisfaction) as well as radiographically, allowing a comparison of the 2 cohorts. Mean outcome scores were similar in the ATSA and the RTSA cohorts, with no difference between the 2 groups. The ATSA group had greater postoperative forward elevation (153° vs 139°; P=.01) than the RTSA group, but no other differences were noted in motion. The ATSA group had less satisfied patients (84% vs 95%), a higher complication rate (21% vs 10%), and a higher revision rate (16% vs 0%) compared with the RTSA group. For post-capsulorrhaphy arthropathy, patients treated with ATSA and patients treated with RTSA had comparable improvements in outcome scores and range of motion. However, the complication rate was higher in the ATSA group. All complications in the ATSA cohort were related to subscapularis insufficiency and postoperative anterior instability problems, resulting in a higher revision rate in this cohort (16%) compared with the RTSA cohort (0%). [Orthopedics. 2018; 41(5):275-280.].