Survivorship of Reverse Shoulder Arthroplasty in Patients Younger Than 55 Years Old

Abstract

Historically, reverse shoulder arthroplasty (RSA) has been reserved for elderly patients. Patients younger than 55 requiring RSA are challenging as they live longer, place more stress and wear on implants, and have higher reoperation rates compared to patients older than 55 years of age. Our goal was to examine the survivorship and functional outcomes of patients younger than 55 years old undergoing RSA. Patients younger than 55 years old who underwent RSA with a minimum two year follow-up were retrospectively reviewed. We evaluated implant survivability, postoperative American Shoulder and Elbow Surgeons (ASES) score, etiology of surgery, and medical demographic data. 29 RSA were performed on 22 patients (7 were bilateral). 20 of the 29 shoulders (68.9%) had a minimum two year follow up and were included for data analysis. Indications for RSA in our patients included: cuff tear arthropathy (14), post-traumatic arthritis (7), rheumatoid arthritis (3), primary osteoarthritis (3), and irreparable rotator cuff repair (2). The average age of the patient at time of surgery was 52.6 years (range 45-54.9 years). Average post-operative ASES score was 80.9 (range 33.3-100.0). There was a statistically significant inverse correlation between number of surgeries on the ipsilateral shoulder and post-operative ASES score (r= -0.55, p= 0.02). No patients included in our data analysis required revision surgery. We conclude that in patients younger than 55 with complex pathology and limited treatment options, RSA provides a durable shoulder arthroplasty option without any early failures at 2-year follow-up.