Pain After Anatomic Total Shoulder Arthroplasty Versus Reverse Total Shoulder Arthroplasty

As anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSAj become increasingly common, differences between the 2 procedures are of importance. The ptiii)ose or this study was to differences in at acute pain levels between patients undergoing a TSA or rTSA. Sixty patients undergoing a TSA or rTSA were assessed for participation. primary outcome was postoperative daily visual analog scale scores, which were initially collected for 4 days postoperatively. Secondary outcomes in eluded opioid consumption, length of stay, and complications. Comparisons between the 2 groups were assessed using a multivariable analysis, which controlled for sex, age, body mass index, and type of anesthetic. A total of 57 patients consented and were analyzed. No significant differences were found in postoperative visual analog sCale scores in the first 4 days following surgery or at 1 year postoperatively. Patients undergoing aTSA had a higher mean opioid requirement in the first 4 hours postoperatively (1.0 +/- 0.7 vs 0.4 +/- 0.6 morphine milligram equivalents, P<.01). Forty percent of patients undergoing shoulder arthroplasty were prescribed narcotics within the 3 months prior to surgery. Patients who were prescribed narcotic prior to surgery were more likely to continue to require narcotics at extended time periods postoperatively. Patients undergoing aTSA required more opioid medication in the immediate postoperative period. However, after 4 hours postoperatively, no significant differences in pain scores or opioid consumption were found. These findings suggest that patients undergoing a TSA or rTSA have similar postoperative pain profiles. Patients who are prescribed narcotics before shoulder arthroplasty are at an increased risk for postoperative opioid demand.