Mid‐term outcomes in patients younger than 65 years undergoing reverse total shoulder arthroplasty demonstrate favourable functional results with high rates of return to activity and work
Lorenz Fritsch, Colby Wollenman, Michael Nocek, Marilee Horan, Brendon Mitchell, Grant Dornan, Alan Villegas Meza, Maximilian Hinz, Marco‐Christopher Rupp, Peter MillettAbstract
Purpose
The aim of the study was to evaluate outcomes, return‐to‐activity and work after reverse total shoulder arthroplasty in patients aged 65 years and younger. We hypothesised that patients would achieve functional improvement, with high rates of return to activity and return to work.
Methods
A retrospective study was conducted for patients aged 65 years and younger who underwent primary reverse total shoulder arthroplasty (2011–2022) with a minimum 24‐month follow‐up. Outcomes included the American Shoulder and Elbow Surgeons score, pain visual analogue scale, Single Assessment Numeric Evaluation, Quick Disabilities of the Arm, Shoulder and Hand outcome measure, and 12‐Item Short Form Health Survey. Return to activity and work were also assessed with questionnaires. Complications, failures and correlations between age and outcomes were analysed.
Results
Seventy‐two shoulders in 68 patients (80% of the original cohort) (mean age, 58.5 ± 8.5 years) were available at mean follow‐up of 6.2 ± 2.4 years. American Shoulder and Elbow Surgeons score (54.9 vs. 89.9), pain visual analogue scale (4 vs. 0), Single Assessment Numeric Evaluation (49 vs. 84), Quick Disabilities of the Arm, Shoulder and Hand outcome measure (40.9 vs. 13.6) and 12‐Item Short Form Health Survey Physical Component (39.6 vs. 51.1) improved postoperatively ( p < 0.001). For the American Shoulder and Elbow Surgeons score, 80% met the minimal clinically important difference and 64% met the patient acceptable symptom state. Younger age correlated with higher post‐operative Single Assessment Numeric Evaluation scores (rho = –0.35, p = 0.003). No or minimal limitations in recreational and sportive activities were observed in 89% of patients. 72% returned to work within 4 weeks, and 95% reported no or slight work limitation, with greater difficulty among manual labourers. One failure (1%) and two complications (3%) occurred.
Conclusion
Reverse total shoulder arthroplasty in patients aged 65 years and younger leads to improved functional outcomes and high patient satisfaction at mid‐term follow‐up. Furthermore, it enables high rates of return to both activity and work with low rates of complication and failure.
Level of Evidence
Level IV.