Does the indication of reverse shoulder arthroplasty affect its outcomes? a meta-analysis

With the rise of reverse shoulder arthroplasty (RSA), its indications expanded to englobe much more than rotator cuff arthropathy such as severe glenoid deformity, massive irreparable rotator cuff tears, and proximal humerus fracture (PHF). Due to these numerous indications, knowing their impact on post-operative outcomes of RSA is important for surgeons. Therefore, this meta-analysis will compare the outcomes of RSA based on its pre-operative indications.

PubMed, Cochrane, and Google Scholar (page 1-20) were searched till October 2025. The clinical outcomes consisted of surgery related outcomes, functional outcome scores, and range of motion.

Eleven studies were included in this meta-analysis. It was shown that patients undergoing RSA for elective indications had a reduced length of stay (Mean difference = - 1.18; p < .001). Furthermore, these patients had a higher post-operative abduction (Standardized Mean difference = 0.17; p = 0.02), flexion (Standardized Mean difference = 0.59; p = 0.02), and external rotation (Standardized Mean difference = 0.42; p = 0.008) than the PHF group.

RSA done for PHF was shown to have a longer length of stay, and worse post-operative ROM. Our results emphasize the importance of fall prevention and tuberosity reduction intra-operatively.