Abstract
Purpose To answer the question whether bilateral reverse total shoulder arthroplasty (RTSA)
is a safe and effective treatment which results in satisfactory clinical and functional
outcomes with low complications rates. A second question to be answered was: what
is the quality of the evidence of the already published studies which investigate
the use of bilateral RTSA?
Methods Two reviewers independently conducted a systematic search according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed
database and the Cochrane Database of Systematic Reviews. These databases were queried
with the terms “reverse” AND “total” AND “shoulder” AND “arthroplasty” AND “clinical.”
Descriptive statistics were used to summarize the data.
Results From the 394 initial studies we finally selected and assessed 6 clinical studies
which were eligible to our inclusion–exclusion criteria. The aforementioned studies
included in total 203 patients (69% females; mean age range: 67.1–75 years; mean follow-up
range: 12–61 months). From those, 168 patients underwent staged bilateral RTSA (mean
duration between first and second operation range: 8–21.6 months) and the rest of
them a unilateral RTSA as controlled treatment. Almost all mean clinical and functional
scores, which were used to assess the therapeutic value of bilateral RTSA, depicted
significant postoperative improvement in comparison with the mean preoperative values.
The modified Coleman methodology score, which was used to assess the quality of the
studies, ranged from a minimum of 36/100 to a maximum of 55/100.
Conclusion Despite the lack of high-quality evidence, staged bilateral RTSA seems to be a safe
and effective procedure for patients with cuff tear arthropathy, which results in
significantly improved clinical and functional outcomes and low reoperations' rates.
Level of Evidence Systematic review of level III-IV therapeutic studies.
Keywords
reverse total shoulder arthroplasty - staged bilateral arthroplasty - cuff tear arthropathy
- systematic review - modified Coleman score
