Clinically Relevant Results of Reverse Total Shoulder Arthroplasty for Patients Younger than 65 Years Compared to the Older Patients

Orthopaedic Surgery Sep 1, 2021

Authors: Hanisch KWJ, Holte MB, Hvass I & Wedderkopp N

In: Arthroplasty 2021; 3(30)

DOI Link: 10.1186/s42836-021-00086-4


Background: Reverse total shoulder arthroplasty was originally designed for older patients with rotator cuff arthropathy and produces good results. The main objective of this retrospective study was to compare the patients younger than 65 years vs. the older patients in terms of the complications of reverse total shoulder arthroplasty and the functional recovery.

Methods: From January 2014 to January 2020, 566 patients who underwent the reverse total shoulder arthroplasty were divided into two groups (group A, ≥ 65 years, n = 506; group B, < 65 years, n = 60). The patients reported the quality of life using the patient-reported Western Ontario Osteoarthritis of the Shoulder index. The Constant score was obtained preoperatively and 3 months postoperatively. The complications and reoperations were compared. Statistical significance was set at P < 0.05.

Results: Clinically relevant improvements were found in group A and B. There was a multivariate statistically-significant but not clinically relevant difference in the change over time between group A and B. The mean 12-month Western Ontario Osteoarthritis of the Shoulder indexes were 58 in group B and 71 in group A. The mean Constant scores were 44 in group B vs. 43 in group A. Compared to group A, group B had a non-significant odds ratio of 1.9, which did not reach the clinically relevant Western Ontario Osteoarthritis of the Shoulder index of group A.

Conclusion: In patients younger than 65 years of age, RTSA seems to be a safe procedure in short term follow-up. After 1 year, we found no increased risk of complications, revision, or inferior outcomes compared to patients older than 65 years of age. Consequently, after one-year, RTSA provided clinically relevant improvements in the patients’ quality of life and shoulder strength regardless of age.


Michael Boelstoft Holte

Head of 3D Lab Denmark