Outcome of reverse shoulder arthroplasty secondary to rotator cuff arthropathy in a low-income population

Background Reverse shoulder arthroplasty (RSA) is a valuable treatment for rotator cuff arthropathy (RCA) in developed regions. Socioeconomic issues impact access to specialized care and there is a lack of data on RSA outcomes in developing regions. We present our 24-month follow-up on RSA surgeries to treat RCA in our low-income population.Methods Prospective evaluation of 26 patients subjected to RSA at Hospital Geral de Fortaleza-CE, Brazil, between January 2018 and December 2020. Literacy [>/<= 8 school years(SY)] and income were documented. Outcomes considered pain (visual analogue scale; VAS) as well as SSV, SPADI, ASES, and UCLA scoring, and range of motion [forward flexion (FF); external rotation (ER)].Results Patients were 68.5 +/- 7.6 years-old with 16(61.5%) females; 65% had hypertension and 7 (26.9%) had diabetes. Over 90% declared < 900.00 US$ monthly family earnings and 10 (38.4%) patients declared <= 8 SY with > 80% exerting blue-collar jobs. Pain showed a significant reduction from baseline (8 +/- 2) to 24 months (2.1 +/- 2.3; p < 0.001). UCLA (10.3 +/- 5.6 and 28.6 +/- 7.2), ASES (16.7 +/- 10.8 and 63.1 +/- 28.4), SSV (326 +/- 311 and 760 +/- 234), and SPADI (98.3 +/- 26.5) scores significantly improved from baseline to 24 months, achieving minimal clinically important difference. FF (89.2 degrees +/- 51.2 degrees to 140.6 +/- 38.3 degrees) and ER (19.2 degrees +/- 22.5 to 33.4 degrees +/- 20.6 degrees) significantly improved from baseline to 24 months (p = 0.004 and 0.027, respectively). There were 5 non-serious adverse events with one surgical revision. All patients returned to daily life activities.Conclusion This is the first outcome report 2 years following RSA in a low-income population. Data indicate this procedure is justifiable regardless of socioeconomic issues.