Long-Term Outcomes Following Reverse Total Shoulder Arthroplasty: A Systematic Review with a Minimum Follow-Up of 10...

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Clinical Outcomes Research

Background:

• Reverse total shoulder arthroplasty (rTSA) is a key procedure for shoulder dysfunction and pain.
• Evaluating long-term clinical and radiological outcomes of rTSA is essential for patient management.

Purpose of the Study:

• To systematically review long-term (≥10 years) clinical and radiological outcomes of rTSA.
• To assess functional improvements, complication rates, and implant survivorship after rTSA.

Main Methods:

• Systematic review of PubMed, Web of Science, Embase, and Cochrane databases until September 2024.
• Inclusion of English/German studies with ≥10-year follow-up; risk of bias assessed.
• Analysis of 7 Level IV studies comprising 469 rTSA procedures in 460 patients.

Main Results:

• Mean follow-up was 12 years with 63% lost to follow-up; 88% revision-free survivorship at 10 years.
• Overall complication rate was 36%, with 23% requiring revision (infection, instability, glenoid issues).
• Significant functional gains observed: Constant Score improved from 27 to 62, ASES from 35 to 74.

Conclusions:

• rTSA provides substantial long-term functional benefits and pain relief.
• High complication and revision rates warrant caution; data quality and follow-up rates are limitations.
• Long-term registry data are crucial for a comprehensive understanding of rTSA outcomes.