Reverse Shoulder Arthroplasty Provided Better Functional Outcomes than Hemiarthroplasty for Acute Proximal Humeral Fractures

Sebastia-Forcada E, Cebrian-Gomez R, Lizaur-Utrilla A, Gil-Guillen V. Reverse Shoulder Arthroplasty Versus Hemiarthroplasty for Acute Proximal Humeral Fractures. A Blinded, Randomized, Controlled, Prospective Study. J Shoulder Elbow Surg. 2014 Oct;23(10):1419-26. ### Question: In older patients with acute complex proximal humeral fractures, how does reverse shoulder arthroplasty (RSA) compare with hemiarthroplasty (HA) for functional outcomes? ### Design: Randomized (allocation concealed), blinded (outcome assessors), controlled trial with at least 2 years of follow-up. ### Setting: A university hospital in Alicante, Spain. ### Patients: 62 patients who were ≥70 years of age with an acute proximal humeral fracture and who were candidates for shoulder arthroplasty because of complex fracture patterns not amenable to reduction and fixation. Exclusion criteria were contraindications to surgery, previous shoulder surgery, associated ipsilateral upper limb fracture, or neurologic disorder. 61 patients (98%) (mean age, 74 years; 85% women) completed follow-up. ### Intervention: Patients were randomly allocated to RSA (n = 31) or HA (n = 30). A modular shoulder replacement system that allowed either an HA or RSA to be performed with the same cementless humeral stem was used …