This PRISMA-compliant systematic review pools data from 52 studies and 5,824 shoulders to establish contemporary benchmarks for primary rTSA outcomes. It asks: what are the real-world complication rates, revision rates, and functional gains with modern implants and technique? Results are compared directly against the landmark 2011 Zumstein review to quantify how much the field has improved.
When a patient asks what to expect from rTSA, these numbers are what you quote: roughly a 1-in-10 chance of any complication, a 1-in-40 chance of needing revision, and a shoulder that goes from 78° to 134° of active flexion.
The historical 24% complication rate from Zumstein's 2011 review — still cited in older textbooks. No longer reflects modern practice. Contemporary lateralized implants and improved surgeon experience have cut that figure to 9.4%.
Scapular notching at 14.4% is now a radiographic finding to monitor, not a near-universal outcome. Choosing a lateralized implant with a 135° neck-shaft angle is the modifiable factor that drives this improvement.
Watch for acromial and scapular spine fractures in your highest-risk patients: elderly women with osteoporosis, rheumatoid arthritis, or rotator cuff tear arthropathy. The rate is 1%–4% and requires a high index of suspicion, since patients may present with new pain and weakness after an initially good result.
This PRISMA-compliant systematic review pools data from 52 studies and 5,824 shoulders to establish contemporary benchmarks for primary rTSA outcomes. It asks: what are the real-world complication rates, revision rates, and functional gains with modern implants and technique? Results are compared directly against the landmark 2011 Zumstein review to quantify how much the field has improved.
When a patient asks what to expect from rTSA, these numbers are what you quote: roughly a 1-in-10 chance of any complication, a 1-in-40 chance of needing revision, and a shoulder that goes from 78° to 134° of active flexion.
The historical 24% complication rate from Zumstein's 2011 review — still cited in older textbooks. No longer reflects modern practice. Contemporary lateralized implants and improved surgeon experience have cut that figure to 9.4%.
Scapular notching at 14.4% is now a radiographic finding to monitor, not a near-universal outcome. Choosing a lateralized implant with a 135° neck-shaft angle is the modifiable factor that drives this improvement.
Watch for acromial and scapular spine fractures in your highest-risk patients: elderly women with osteoporosis, rheumatoid arthritis, or rotator cuff tear arthropathy. The rate is 1%–4% and requires a high index of suspicion, since patients may present with new pain and weakness after an initially good result.