Reverse total shoulder arthroplasty outcomes in elderly patients.

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Biomedical Engineering

Background:

• Outcomes of reverse total shoulder arthroplasty (rTSA) in elderly patients vary, with limited data on very old populations.
• This study addresses the scarcity of research on rTSA outcomes in patients aged 85 and older.

Purpose of the Study:

• To analyze functional and radiographic outcomes of rTSA in patients aged 85 years and older.
• To compare these outcomes with a matched younger patient cohort.

Main Methods:

• Retrospective analysis of 1460 rTSA cases (2005-2020), identifying 74 patients ≥85 years.
• 42 elderly patients (mean age 87) with ≥2-year follow-up were matched to a younger cohort (mean age 69.5).
• Outcomes assessed via range of motion (ROM), pain scores, patient satisfaction, and radiographic evaluation for complications.

Main Results:

• Significant improvements in relative Constant-Murley Score (CMS) and subjective shoulder value were observed in the elderly cohort.
• Most ROM aspects, abduction force, and pain improved significantly; external rotation showed no significant change.
• Radiolucency, bone formation, and implant migration were linked to poorer absolute CMS. Complication and revision rates were low (2.4% revision).
• No significant differences in functional outcomes (relative CMS, subjective shoulder value, ROM) were found between the ≥85 group and the younger matched cohort.

Conclusions:

• rTSA in patients aged 85 and older yields significant functional improvements and pain reduction.
• Clinical outcomes are comparable to younger patient populations.
• Low complication and revision rates suggest age alone should not preclude rTSA consideration.