Anatomic TSA vs RTSA for Glenohumeral Arthritis

May 19, 2026 updated by: Dr. Alexandre Lädermann, La Tour Hospital

Anatomic Versus Reverse Shoulder Arthroplasty for Primary Glenohumeral Osteoarthritis. A Randomized Prospective Study

There are no published prospective studies that compared 2-year functional outcomes of RTSA and anatomic TSA for the treatment of primary glenohumeral osteoarthritis with intact rotator cuffs and no excessive glenoid retroversion. The primary goal of our prospective randomized study is to determine whether RTSA have at least as good results as anatomic TSA (non-inferiority), in patients with glenohumeral osteoarthritis, without rotator cuff tears nor significant glenoid retroversion.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Total anatomic shoulder arthroplasty (TSA) is an effective treatment of severe glenohumeral osteoarthritis, with significant improvement in shoulder pain and function. Concerns about glenoid loosening, associated with difficult revision procedures and disappointing outcomes, have however been raised.

Reverse total shoulder arthroplasty (RTSA) was designed with a medialized center of rotation to treat cuff tear arthropathy. Favorable early reports led to the expansion of primary indications of RTSA to proximal humeral fractures as well as osteoarthritis with poor glenoid bone stock. Recent reports revealed excellent clinical results of RTSA for primary glenohumeral arthropathy with intact rotator cuff and a low rate of complications.

Retrospective studies comparing functional results - of anatomic TSA for treating glenohumeral osteoarthritis with RTSA for rotator cuff arthropathy - found equivalent or greater improvements in American Shoulder and Elbow Surgeons score (ASES) at >2-year follow-up. In a study comparing anatomic TSA to RTSA for the treatment of glenohumeral osteoarthritis with intact rotator cuffs, Steen et al. reported equivalent functional results at >2-year follow-up. The retrospective matched cohort study could, however, not eliminate biases, such that RTSA patients had higher preoperative glenoid retroversion than anatomic TSA patients. The authors therefore hypothesize that, in patients treated for glenohumeral osteoarthritis without excessive glenoid retroversion, RTSA will render better functional outcomes than anatomic TSA, at 2 postoperative years. Many other studies confirmed in 2019 Steen's hypothesis. Moreover, several studies revealed good long-term survivorship after RTSA.

There are no published prospective studies that compared 2-year functional outcomes of RTSA and anatomic TSA for the treatment of primary glenohumeral osteoarthritis with intact rotator cuffs and no excessive glenoid retroversion. The primary goal of our prospective randomized study is to determine whether RTSA have at least as good results as anatomic TSA (non-inferiority), in patients with glenohumeral osteoarthritis, without rotator cuff tears nor significant glenoid retroversion.The secondary goals are 1) to evaluate whether RTSA eventually grants superior postoperative clinical and radiographic outcomes than anatomic TSA (superiority), 2) to determine whether RTSA is associated with fewer postoperative complications than anatomic TSA.

Study Type

Interventional

Enrollment (Estimated)

296

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

65 years to 85 years (Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Primary glenohumeral arthritis,
  • Intact rotator cuff,
  • No important glenoid bone loss (cf exclusion criteria),
  • Patients between 65 and 85 years old
  • Informed Consent as documented by signature (Appendix Informed Consent Form).

Exclusion Criteria:

  • B2 glenoid with > 80% posterior humeral head subluxation or greater 25 degrees neoglenoid retroversion,
  • B3 and C type glenoids,
  • Full thickness rotator cuff tear,
  • Acute or malunited proximal humeral fracture,
  • Chronic locked dislocation
  • Rheumatoid arthritis,
  • Revision surgery or surgical antecedents,
  • Tumors,
  • Axillary nerve damage,
  • Non-functioning deltoid muscle,
  • Glenoid vault deficiency precluding baseplate fixation,
  • Infection and neuropathic joints,
  • Known or suspected non-compliance, drug or alcohol abuse,
  • Patients incapable of judgement or under tutelage,
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, contraindication for CT scan etc. of the participant,
  • Enrolment of the investigator, his/her family members, employees and other dependent persons.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Anatomic TSA
The control group will receive through a deltopectoral approach an anatomic total shoulder arthroplasty (TSA) for a primary glenohumeral arthritis
Device: Total shoulder arthroplasty
A prosthesis (either anatomic or reverse) will be implanted in shoulders patients that suffer from primary glenohumeral arthritis.
Experimental: RTSA
The experimental group will receive through a deltopectoral approach a reverse total shoulder arthroplasty RTSA for a primary glenohumeral arthritis
Device: Total shoulder arthroplasty
A prosthesis (either anatomic or reverse) will be implanted in shoulders patients that suffer from primary glenohumeral arthritis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in American Shoulder and Elbow Surgeons score (ASES)
Time Frame: Between baseline and 2 postoperative years
General clinical score (0-100, with 100 being the best score possible)
Between baseline and 2 postoperative years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Subjective Shoulder Value (SSV)
Time Frame: Between baseline and 2 postoperative years
General clinical score (0-100, with 100 being the best score possible)
Between baseline and 2 postoperative years
Change in Range of motion in degrees
Time Frame: Between baseline and 2 postoperative years
(anterior forward flexion, external rotation at the side, internal rotation to nearest spinal level)
Between baseline and 2 postoperative years
Complication rates
Time Frame: 2 postoperative years.
2 postoperative years.
Change in pain on visual analogic scale (pVAS)
Time Frame: Between baseline and 2 postoperative years
General clinical score (0-10, with 10 the worst score possible)
Between baseline and 2 postoperative years
Change in Constant score
Time Frame: Between baseline and 2 postoperative years
General clinical score (0-100, with 100 being the best score possible)
Between baseline and 2 postoperative years
Change in Short Form -12 (SF-12)
Time Frame: Between baseline and 2 postoperative years
General clinical score (0-100, with 100 being the best score possible)
Between baseline and 2 postoperative years
Radiographic outcomes
Time Frame: 2 postoperative years
Rates of aseptic loosening, implant migration, implant tilt, scapular notching, glenoid bone loss as defined previously by the investigator
2 postoperative years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

La Tour Hospital

Investigators

  • Principal Investigator: Alexandre Lädermann, MD, La Tour Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2020

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

May 1, 2027

Study Registration Dates

First Submitted

August 25, 2020

First Submitted That Met QC Criteria

November 13, 2020

First Posted (Actual)

November 16, 2020

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 19, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2019-02471

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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