Health-related quality of life and functionality after reverse shoulder arthroplasty

Modern semiconstrained reverse shoulder arthroplasty (RSA) has shown a great improvement in function and range of motion (ROM) in different etiologies, including revision surgery, sequelae of fractures, or tumors. Few studies have evaluated RSA for primary glenohumeral osteoarthritis, massive rotator cuff tear, or cuff tear arthropathy excluding any other shoulder disease, and data on patients' quality of life after this surgery are lacking.

In this prospective cohort study, 80 patients were evaluated after an RSA for either primary osteoarthritis, massive rotator cuff tear, or cuff tear arthropathy with the Constant-Murley score (CMS), ROM, and Short Form Health Survey (SF-36). A radiologic assessment was performed preoperatively and postoperatively in 62 of these patients.

At a mean 5-year follow-up, the cumulative survival rate was 97.3% and significant improvements in the CMS and ROM were observed when compared with the baseline values. The CMS was 93.2% of the sex- and age-matched normal values. The postoperative SF-36 scores showed no significant differences compared with normative data. Younger patients and subjects with worse preoperative conditions achieved the greatest benefit after RSA. The length of follow-up was found to be associated with the severity of scapular notching.

This study introduces new predictors for surgical outcomes, and it shows that patients who had undergone RSA a mean of 5 years earlier exhibit similar functionality and health-related quality of life with respect to healthy controls. Physicians should consider these results when discussing the outcomes of this surgery with patients.

Level IV, Case series, treatment study.