Minimum 10-year survivorship and risk factors for failure following reverse total shoulder arthroplasty
Rodrigo Saad Berreta, Daniel Badin, Henry Fox, Lincoln D. Koyejo, Sami Almasri, Ahlam Ashkar, Debra Chan, Ethan Harris, Umasuthan SrikumaranBackground
Prior studies have explored risk factors for short- and mid-term failure following reverse total shoulder arthroplasty (RTSA), but data characterizing factors associated with long-term survivorship remain limited.
Methods
A retrospective cohort study using the PearlDiver Mariner database identified patients who underwent RTSA from 2010 to 2013 with a recorded healthcare claim at least 10 years after the index procedure. Failure was defined as revision prior to final follow-up. Kaplan–Meier survival analysis estimated survivorship at two, five, and 10 years, and multivariate logistic regression identified risk factors for failure.
Results
Of 5269 patients identified, 273 (5.2%) underwent revision surgery. One-, five-, and 10-year survival rates were 97.8%, 95.7%, and 95.0%, respectively. Mean time to revision was 2.5 years (median 1.4 years). In multivariate analysis, each additional year of age was associated with approximately 4% lower odds of revision (odds ratio (OR): 0.96), indicating higher odds among younger patients. Male sex (OR: 1.58), prior rotator cuff repair (OR: 1.49), and a primary diagnosis of glenohumeral osteoarthritis (OR: 1.34) were significantly associated with increased odds of reoperation.
Conclusion
RTSA demonstrates excellent 10-year survivorship with a low revision rate. Male sex, younger age, prior rotator cuff repair, and glenohumeral osteoarthritis were independent risk factors for long-term failure.
Level of Evidence
Level IV