TSA vs RSA in Glenohumeral Osteoarthritis

This randomized controlled trial is comparing two types of shoulder replacement surgery — total shoulder arthroplasty (TSA), which replaces the worn joint surfaces while maintaining the natural shoulder anatomy, and reverse shoulder arthroplasty (RSA), which flips the ball-and-socket design — in patients aged 65 and older with glenohumeral shoulder osteoarthritis and mild-to-moderate socket bone erosion. Both procedures are used to treat severe shoulder arthritis, but evidence directly comparing their outcomes in older patients is limited. Adults 65 or older with confirmed advanced shoulder osteoarthritis who have failed non-surgical treatment for at least 6 months, have up to 15 degrees of socket bone erosion, and do not have rotator cuff problems or prior shoulder surgery on the affected side are eligible. Participants will undergo one of the two assigned surgeries and be followed with questionnaires and imaging at 2 years and 5 years to evaluate pain, function, and quality of life. This summary was prepared to help patients understand the study in plain language.