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Objectives To answer a national research priority by comparing the risk-benefit and costs associated with reverse total shoulder replacement (RTSR) and anatomical total shoulder replacement (TSR) in patients having elective primary shoulder replacement for osteoarthritis. Design Population based cohort study using data from the National Joint Registry and Hospital Episode Statistics for England. Setting Public hospitals and publicly funded procedures at private hospitals in England, 2012-20. Participants Adults aged 60 years or older who underwent RTSR or TSR for osteoarthritis with intact rotator cuff tendons. Patients were identified from the National Joint Registry and linked to NHS Hospital Episode Statistics and civil registration mortality data. Propensity score matching and inverse probability of treatment weighting were used to balance the study groups. Main outcome measures The main outcome measure was revision surgery. Secondary outcome measures included serious adverse e

United kingdomUnited statesCity ofRafael pinedo villanuevaEpaminondas markos valsamisIan koblbauerAlbert prats uribeGarys collinsDaniel prieto alhambraAdrian sayersJonathanl reesSophie coleMonte carloMichaelr whitehouseHealthcare quality improvement partnershipInnovative medicines initiative