Reverse shoulder arthroplasty in older patients: is it worth it? A subjective functional outcome and quality of life survey

Abstract

Our study confirms that RSA represents a useful solution for end-stage shoulder disease also in the advanced age population.

What Are the Complications, Survival, and Outcomes After Revision to Reverse Shoulder Arthroplasty in Patients Older Than 80 Years?

“…Regarding surgical complications and reoperation rate, the 13% chance observed in our study does not seem exceedingly high considering the sample characteristics. Overall, the reoperation rate in our patients is slightly higher compared with those reported in other studies including primary anatomic replacement and RSA (Table 3) [3,7,15,17].…”

“…None of the previous studies included revision arthroplasty in patients older than 80 years ( Table 3). In general, shoulder arthroplasty provides substantial pain relief and increase in ROM [3,7,15,17]. Forward flexion and external rotation in our study patients were slightly lower [3,7] compared with those reported in other studies (Table 3).…”

“…At a median followup of 5.5 years, Foruria et al [7] reported glenoid loosening and revision arthroplasty rates of 8% and 7% in primary anatomic shoulder arthroplasty performed in octogenarians, respectively (Table 3). Using primary RSA in patients older than 80 years, Mangano et al [15] reported no glenoid component loosening at a mean followup of 59 months (Table 3). Patients older than 80 years should be advised that survival after revision to RSA is lower than after primary anatomic replacement or RSA.…”

Quality of Life in Patients With Rotator Cuff Arthropathy

“…Castricini et al, 8 in a study on the use of reverse arthroplasty of the shoulder in degenerative disorders (arthropathy of the rotator cuff, irreparable rupture of the rotator cuff, and primary glenohumeral arthritis), noted that the procedure provides QOL similar to that of the healthy population. Mangano et al 15 found similar results, studying only elderly patients. In a study on the use of reverse arthroplasty in proximal fractures of the humerus, Lopiz et al 9 also observed final QOL outcomes comparable to the unaffected population.…”

“…Analyzes of QOL in indicating surgery are not cited in this or other studies. 8 , 14 , 15 We believe that QOL should be evaluated before and after arthroplasty, and should be part of the clinical reasoning at the time surgery is recommended. Many patients with this condition are elderly, with comorbid conditions and limitations inherent to age.…”