These authors compared the outcomes of 19 patients having a TSA in 1 shoulder and an RSA in the contralateral shoulder.
They concluded that was statistically significant greater internal rotation in the TSA shoulder (P = .044) but no significant difference in forward elevation (P = .573) or external rotation (P = .368). There was no radiographic evidence of humeral or glenoid component loosening of any arthroplasty implants. There were no significant differences between TSA and RSA shoulders for the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (P = .381), Simple Shoulder Test (P = .352), Single Assessment Numerical Evaluation (P = .709), and visual analog scale satisfaction (P = .448) or pain scores (P = .305). Thirteen patients (68.4%) preferred the RSA side, 1 patient (5.3%; z = 4.04, P < .001) patient preferred the TSA side, and 5 patients expressed no preference.
The authors concluded that the only parameter in which the TSA had superior outcomes was internal rotation. They state that "There were no significant differences between TSA and RSA shoulders for ASES (87.0 ± 11.6 vs. 81.5 ± 20.6, P = .381), SST (8.4 ± 2.8 vs. 7.4 ± 2.7, P = .352), SANE (82.0 ± 19.8 vs. 79.1 vs. 21.7, P = .709), VAS satisfaction (8.7 ± 1.9 vs. 8.0 ± 2.8, P = .448), or VAS pain scores (0.7 ± 1.4 vs. 1.5 ± 2.3, P = .305), respectively (Table III )".
The authors concluded that the only parameter in which the TSA had superior outcomes was internal rotation. They state that "There were no significant differences between TSA and RSA shoulders for ASES (87.0 ± 11.6 vs. 81.5 ± 20.6, P = .381), SST (8.4 ± 2.8 vs. 7.4 ± 2.7, P = .352), SANE (82.0 ± 19.8 vs. 79.1 vs. 21.7, P = .709), VAS satisfaction (8.7 ± 1.9 vs. 8.0 ± 2.8, P = .448), or VAS pain scores (0.7 ± 1.4 vs. 1.5 ± 2.3, P = .305), respectively (Table III )".
Comment: In concluding that there is "no difference", it is important to consider statistical power. Power analyses regarding the hypothesis to be tested are best done in advance of the conduct of the study along with a sample size estimate. A post hoc power analysis can also be done to answer a question such as, "how sure can we be that there is no difference in the SST scores?"
A post hoc analysis of the SST results in this shows that we can on only have 20% confidence that there is "no difference".
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