Early Versus Late Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Does It Matter?



1 Department of Orthopedics, The University of Colorado, Aurora, USA The Rothman Institute, Thomas Jefferson University, Philadelphia, USA

2 The Rothman Institute, Thomas Jefferson University, Philadelphia, USA


Background: This study compared the outcomes between patients with proximal humerus fractures (PHF) who
underwent acute reverse total shoulder arthroplasty (RSA) to those who underwent an alternative initial treatment
before requiring (secondary) RSA.
Methods: Patients who underwent RSA after suffering a PHF were identified. Two year clinical follow-up was required
for inclusion. Patients were divided into an acute group (RSA secondary RSA group was subdivided by initial treatment (non-operative, hemiarthroplasty, open reduction internal
fixation (ORIF)). Clinical and radiographic outcomes were compared.
Results: Forty-seven patients met inclusion criteria with 15 in the acute RSA group and 32 in the secondary RSA group.
The acute RSA group demonstrated better external rotation (28˚) than the secondary RSA group (18˚, P=0.0495). The
acute RSA group showed a trend towards better Single Assessment Numeric Evaluation (SANE) scores. Tuberosity
healing rate was higher in the acute RSA group.
Conclusion: While acute and secondary RSA can yield successful outcomes, acute RSA results in a higher tuberosity
healing rate and improved external rotation.


Main Subjects