Long-term results of reverse shoulder arthroplasty

Background Reverse shoulder arthroplasty (RSA) is steadily gaining influence in the treatment of degenerative pathologies, fracture treatment posttraumatic situations, revision and tumor surgery of the shoulder. Objectives Determination of subjective results and clinical function such as range of motion and complication of RSA (Grammont type, 155 degrees) in long-term results in relation to indication. Materials and methods Evaluation of clinical studies with regard to long-term results, discussion of latest developments and expert opinions. Results RSA provides very good results for patients with irreparable massive rotator cuff tears, cuff-tear arthropathy and glenohumeral osteoarthritis with regard to pain relief and improvement in range of motion and function. Even patients suffering from proximal humerus fractures, fracture sequelae, tumors or in revision situations benefit from treatment with RSA. Although there is a high rate of scapular notching reported in the literature of up to 95% in long-term results, patients reach satisfying functional results with a mean Constant score of about 60 points (maximum & x202f;= 100 points). Although more than one quarter of patients display notching of grade 3 to 4 & x202f;at long-term follow-up, RSA demonstrates a 10-year survival of 90% with a revision rate of 10%. While range of motion and strength seem to decline around 8 years after implantation, patients' satisfaction remains unaffected. Patients with massive rotator cuff tears, cuff-tear arthropathy and glenohumeral osteoarthritis achieve the best results, whereas patients after revision surgery and fracture sequelae perform worse. Conclusion RSA provides reliable and good clinical results in primary surgery as well as in revisions. While scapular notching is frequently observed, patients still profit from this treatment in the long run.