Bridging Reconstruction Versus Reverse Total Shoulder Arthroplasty for the Management of Massive, Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis

Bridging allograft reconstruction (BAR) and reverse shoulder arthroplasty (RSA) are 2 approaches for managing massive, irreparable rotator cuff tears, both yielding satisfactory functional results. A systematic review of 28 studies encompassing 1125 cases treated with either technique revealed significant improvement in range of motion and functional scores across all patients. However, BAR led to a notably greater improvement in external rotation. RSA exhibited significantly higher complication rates (18.6%) and an increased likelihood of reoperation (7.9%). Patients younger than 70 undergoing RSA faced higher complication and reoperation risks at 26% and 12.5%, respectively. In summary, BAR offers comparable functional outcomes with fewer complications compared with RSA for managing massive, irreparable rotator cuff tears. Patients under age 70 being considered for RSA should understand their heightened risks.