This retrospective database study of 6,382 patients compares the types, rates, and timing of complications after aTSA and rTSA. All procedures used a single contemporary platform implant performed by 40 surgeons across the US and Europe. The central question: do these two constructs fail the same way, or differently?
When consenting a patient for aTSA, counsel them specifically about two distinct failure modes with very different timelines: subscapularis failure (mean 22.5 months, revision rate 1.9%) and aseptic glenoid loosening (mean 55.8 months, revision rate 1.9%). Both drive roughly one-third of all aTSA revisions each.
For rTSA patients, set expectations around acromial stress fractures — common (1.7%) but almost never requiring reoperation. And instability, which is rare (1.4%) but accounts for 38.5% of all rTSA revisions when it occurs. The equivalence of infection rates between constructs (P=0.1605) means your infection prevention protocol should be identical regardless of which implant you use.
One practical nuance: aseptic glenoid loosening in aTSA presents at nearly 5 years on average. A patient who feels fine at their 1-year or 2-year visit is not in the clear. Long-term follow-up is essential for aTSA surveillance.
This retrospective database study of 6,382 patients compares the types, rates, and timing of complications after aTSA and rTSA. All procedures used a single contemporary platform implant performed by 40 surgeons across the US and Europe. The central question: do these two constructs fail the same way, or differently?
When consenting a patient for aTSA, counsel them specifically about two distinct failure modes with very different timelines: subscapularis failure (mean 22.5 months, revision rate 1.9%) and aseptic glenoid loosening (mean 55.8 months, revision rate 1.9%). Both drive roughly one-third of all aTSA revisions each.
For rTSA patients, set expectations around acromial stress fractures — common (1.7%) but almost never requiring reoperation. And instability, which is rare (1.4%) but accounts for 38.5% of all rTSA revisions when it occurs. The equivalence of infection rates between constructs (P=0.1605) means your infection prevention protocol should be identical regardless of which implant you use.
One practical nuance: aseptic glenoid loosening in aTSA presents at nearly 5 years on average. A patient who feels fine at their 1-year or 2-year visit is not in the clear. Long-term follow-up is essential for aTSA surveillance.