The Evolution of Reverse Shoulder Arthroplasty: A Review of Complications and the Rising Concern of Overuse

Reverse shoulder arthroplasty (RSA) was initially developed to manage cuff tear arthropathy in elderly patients. It has since become increasingly popular due to its ability to provide pain relief, enhance stability, and improve function in various complex shoulder pathologies. This review examines the evolution of RSA, including its expanded indications for use, complications, and the rising concern of potential overuse. While RSA has shown significant benefits in selected cases, its growing application in younger and more active patients raises questions about long-term outcomes and durability. Complications such as instability, infection, baseplate failure, and scapular notching remain substantial challenges, particularly in revision cases. The article emphasises the need for cautious patient selection and evidence-based practice to avoid overuse and ensure optimal patient outcomes. Future high-quality research with extended follow-up is essential to better understand RSA's long-term efficacy and safety, particularly in diverse and younger patient populations.