Outcomes of Reverse Total Shoulder Arthroplasty in Patients 60 Years of Age or Younger: A Systematic Review

Purpose Reverse total shoulder arthroplasty (RTSA) has been traditionally performed in elderly, low-demand patients. However, indications for RTSA are expanding, and patients who potentially benefit fromthis procedure are not restricted to those who are elderly. The purpose of this review was to summarize reported outcomes of RTSA in patients aged 60 years or younger. Methods We performed a systematic review of the literature to search for outcomes of RTSA in patients aged 60 years or less. Inclusion criteria were studies reporting clinical and/or functional outcomes of RTSA in patients aged 60 years or less with follow-up of greater than 2 years. Cadaveric studies and studies including patients aged greater than 60 years were excluded. Outcomes of interest were range of motion, functional scores (Constant, American Shoulder and Elbow Surgeons, Simple Shoulder Test, and visual analog scale for pain), implant survival, and complications. Results Four studies with a total of 193 patients met inclusion criteria with mean durations of follow-up of 34 to 140.4 months. At the final follow-up, all studies showed significant improvements in flexion, abduction, and all reported functional scores. Mean postoperative flexion and abduction ranged from 85 degrees to 134 degrees and from 79 degrees to 111 degrees, respectively. Implant survival ranged from 87.5% to 94.3% at the latest follow-up. Complication rates ranged from 15% to 39.1%. Conclusions Early clinical and functional outcomes of RTSA in patients aged 60 years or less are favorable. Long-term functional results and implant survival rates of RTSA are comparable to previous data from older patients. Copyright (C) 2020 by the American Society for Surgery of the Hand. All rights reserved.