Anatomic or reverse shoulder arthroplasty for cuff intact glenohumeral osteoarthritis.

Shoulder Elbow · Oct 2025 · Review

Atwan Y, Walton MJ, Watts AC, Trail IA

Department of Trauma and Orthopaedics, Wrightington Upper Limb Unit, Wigan, UK

Shoulder & Elbow Sports Medicine

SUMMARY — THE REDUCTIONThis paper describes the rationale and design of the RAPSODI trial, which will compare anatomic versus reverse shoulder arthroplasty, including cost effectiveness, for glenohumeral osteoarthritis with an intact rotator cuff.
Abstract, as published

Glenohumeral osteoarthritis in the presence of an intact rotator cuff is a debilitating condition that often leads to surgical intervention in the form of joint arthroplasty. Historically, anatomic total shoulder replacement (ATSR) had been considered the treatment of choice. Over the past decade, however, there has been a shift in treatment patterns to the use of reverse shoulder replacement to treat this condition due to concerns of subsequent rotator cuff failure and glenoid component loosening with ATSR. With continued innovation of implants and surgical techniques, it is unclear which procedure provides the best outcomes for patients. The Reverse or Anatomical replacement for Painful Shoulder Osteoarthritis, Differences between Interventions trial aims to definitively answer this question and evaluate the cost effectiveness of both procedures.

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