Categories
Change Password!
Reset Password!
In patients older than 80 years of age, reverse
total shoulder arthroplasty (RTSA) has a low medical complication rate and an
excellent improvement of shoulder pain and function.
A recent study illustrated that, despite a quite high postoperative complication rate, RTSA is a promising therapeutic choice, with an unexpectedly low medical complication rate and a good to excellent improvement of shoulder function and pain in patients older than 80 years of age.
A study was carried out to explore the outcome of primary RTSA in a patient cohort older than 80 years of age. Between January 2005 and March 2018, 171 shoulders (159 patients; 120 females), treated with an RTSA at an age of more than 80 years (mean age of 84 ±3 years) were recruited in this analysis.
Mortality, Subjective Shoulder Value (SSV) and the Constant-Murley Scores, complications, and reoperation rates were the primary endpoints. Adverse radiographic outcomes were the secondary outcome parameters. Due to the high patients' age, a minimum follow-up of 1 year was accepted in 14 patients.
Cuff tear arthropathy, isolated rotator cuff tear, and fracture were the main indications for RTSA.
136 (79%) were eligible for a physical examination and were followed-up for a mean period of 41±25 (minimum 12 to maximum 121) months.
An improvement in pain was witnessed. The relative constant scores and SSV improved remarkably, as shown in the following table:
The range of motion and force improved considerably. The surgical site complication rate was found to be 30%. The reoperation rate was found to be 8% (13 patients) primarily due to glenoid loosening and fracture. The mean time to death was 53 ± 31 months, and the overall mortality was found to be 16%.
The age-adjusted, expected mortality rate without this procedure was not found to higher.
Thus, in patients older than 80 years of age, RTSA is a significant therapeutic option as it can effectively alleviate pain, improve shoulder function, and possess a low medical complication rate.
Journal of Shoulder and Elbow Surgery
Primary Reverse Total Shoulder Arthroplasty in Patients older than 80 years of age: Clinical and Radiological Outcome Measures
Philipp Kriechling
Comments (0)