Revision-free reverse shoulder arthroplasty patients report greater difficulty with some activities of daily living compared to anatomic total shoulder arthroplasty patients at mid-term follow-up

Background: Few studies have directly compared limitations in activities of daily living (ADLs) between reverse shoulder arthroplasty (RSA) and anatomic total shoulder arthroplasty (aTSA). This study evaluates ADL function at mid-term follow-up in patients with revision-free RSA and aTSA. Methods: This retrospective cohort study included 250 patients who underwent primary aTSA (n = 177) or RSA (n = 73) with a minimum follow-up of 7 years (mean 10 ± 2 years). Patients who had revision surgery were excluded. Multivariable ordinal logistic regression analysis was used to assess the odds of RSA patients reporting better ADL function compared to aTSA patients. Results: Postoperatively, a greater proportion of aTSA patients reported normal ADLs compared to RSA patients. On multivariable analysis, controlling for baseline differences, RSA patients reported lower ADL function for personal hygiene/toilet needs (Odds ratio [OR] 0.21 [95% CI: 0.07-0.65]; p = 0.006), washing/combing hair (OR 0.36 [0.13-1.02]; p = 0.049), putting on a button-up shirt (OR 0.08 [0.02-0.25]; p < 0.001), and putting on pants (OR 0.12 [0.03-0.39]; p < 0.001). Discussion: After adjusting for differences in baseline factors, RSA patients reported greater difficulty with specific ADL tasks-including toileting, personal hygiene, grooming, and dressing-compared to aTSA patients. Level of Evidence: Level III; Retrospective cohort study.