Reverse shoulder replacement for the treatment of proximal humerus fractures: a current literature review

Reverse shoulder arthroplasty (RSA) received Food and Drug Administration approval in 2003 and has become one of the most performed orthopedic procedures. Proximal humerus fractures (PHFs), in particular, have become a very common indication for RSA. Specifically, 3-part and 4-part fractures in older individuals with poorer bone quality and/or limited physical demands are amenable to RSA. Given the aging population, the use of RSA for the treatment of PHFs is expected to increase. However, the complex nature of PHF morphology and the multiple treatment options underscores the fact that not every patient or every PHF is indicated for RSA. Therefore, it is important to develop a thorough understanding of indications and contraindications of RSA in the setting of PHF. Overall, this procedure provides adequate functional outcome scores, range of motion, and pain control as compared to other surgical treatments for PHFs. The purpose of this review is to provide a comprehensive and critical overview of the history, indications, surgical considerations and complications, postoperative course, and future of RSA specifically within the context of PHFs.