Reverse shoulder arthroplasty in upper extremity ambulators: a matched-cohort analysis

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Rehabilitative Medicine

Background:

• Upper extremity ambulators (UEAs) face high shoulder pathology risk due to assistive device use.
• Reverse shoulder arthroplasty (RSA) historically had complications in UEAs, but recent data is more promising.

Purpose of the Study:

• To evaluate clinical outcomes and complication rates of RSA in UEAs compared to controls.
• To define the relative risk of RSA in the UEA population.
• To identify opportunities for improved treatment outcomes in UEAs.

Main Methods:

• Retrospective chart review of 159 RSA procedures (2004-2019).
• UEAs defined as patients using regular upper extremity assistive devices.
• Comparison of pre- and postoperative outcomes (ROM, pain, function scores) and complications.

Main Results:

• UEA patients had higher preoperative pain and lower function than controls (p < 0.05).
• Postoperative outcomes were similar, except for reduced forward flexion in UEAs (p=0.0354).
• Notching and complication rates were comparable between UEA and control groups (14.3% vs. 13.5%).

Conclusions:

• RSA in UEAs achieves similar pain and functional outcomes to controls without increased complications.
• Further long-term studies are needed for this patient population.