Reverse total shoulder arthroplasty provides better shoulder function than hemiarthroplasty for displaced 3- and 4-part proximal humeral fractures in patients aged 70 years or older: a multicenter randomized controlled trial

BackgroundThe most appropriate treatment for displaced multiple-fragment proximal humeral fractures in elderly patients is currently unclear. Reverse total shoulder arthroplasty (rTSA) a promising option that being used increasingly. The purpose of this study was to compare the outcome rTSA vs. hemiarthroplasty (HA) 3- and 4-part patients.MethodsThis multicenter randomized controlled trial. We included aged ? 70 years with or between September 2013 May 2016. minimum follow-up period 2 years, measures including Constant score (primary outcome), Western Ontario Osteoarthritis Shoulder index, EQ-5D (EuroQol 5 Dimensions) range motion, as well pain satisfaction assessed on visual analog scale.ResultsWe 99 (48 patients) HA (51 patients). Fifteen were lost follow-up, leaving 41 43 analysis. mean age 79.5 there 76 women (90%). group had 58.7 points compared 47.7 group, difference 11.1 (95% CI, 3.0-18.9 points; P = .007). Compared patients, greater (79 mm 63 mm, .011), flexion (125° 90°, < .001), abduction (112° 83°, but no pain, index scores. identified 3 4 adverse events groups, respectively. Among 80 (n 38), (17 9 .17) (77 74 .73).ConclusionWe found provides better function than measured score, further emphasized by more satisfied their function. appears be mainly result motion (abduction flexion) group. results also indicate benefit less from 70-79 years. patients. This scale. .73).