Reverse total shoulder arthroplasty now makes up more than half of the shoulder arthroplasties reported to the American Academy of Orthopaedic Surgeons’ Shoulder & Elbow Registry. Of 39,251 procedures, 52.7% were reverse and 35.1% were anatomic, with use of the reverse procedure increasing with patient age.
The finding comes from the registry’s 2026 annual report, which the AAOS released Sept. 23. The seventh edition of the report includes 73,478 shoulder and elbow procedures performed from 2015 through 2025, a 25.3% increase over last year’s report. It draws on data from 823 surgeons at 159 facilities across 41 states. For the first time, the report also includes data on individual implant components.
The report also found a continued decline in subacromial decompression during arthroscopic rotator cuff repair. The procedure was performed in 39.5% of repairs, in line with national data and the AAOS’ 2025 clinical practice guideline, which does not suggest routine acromioplasty for small- to medium-size full-thickness tears.
Patients also reported substantial improvement one year after surgery. Average American Shoulder and Elbow Surgeons scores rose from 40 before surgery to 76.4 at one year, and average Single Assessment Numeric Evaluation scores rose from 40 to 78.9. Among patients with both preoperative and one-year assessments, 84% saw clinically meaningful improvement on the ASES measure and 81.4% on SANE, the report said.
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