Clinical Results of a Short Metaphyseal Reverse Total Shoulder Arthroplasty in Patients Aged 65 or Younger: 2 to 11 Years Follow up

To observe the outcome and the radiological results of a short metaphyseal reverse total shoulder arthroplasty (rTSA) in patients aged 65 or younger.

We evaluated 44 patients (29 F, 15 M) with a mean age of 59±6 years (range, 39-65 years), who underwent a short metaphyseal rTSA between 2006 and 2015. Indications were cuff tear arthropathy, rheumatoid arthritis, primary osteoarthritis and fracture sequelae. 17 were revisions. Patients were prospectively assessed both clinically and radiographically preoperatively, at 3weeks, 3, 6, 12, 24months and yearly postoperatively: Constant Score (CS), Subjective Shoulder Value (SSV), Patient Satisfaction Score (PSS) were used.

At 2 years’ follow-up, the mean CS improved from 18.1±11.9 to 60.1±18.6 (p<0.001) and the mean SSV improved from 11.5±3.5 to 3.9±3.3 (p<0.001). The mean active elevation was 141.1°±41.9° (p<0.001) with an improvement of 82.7°±39.9°, the active abduction 136.8°±44.7° (p<0.001) with an improvement of 87°±42°, the active external rotation 36.9°±21.4° (p<0.001) with an improvement of 16°±22° and the active internal rotation 66.2°±23.1° (p<0.001) with an improvement of 40.1°±35°. All the patients rated their shoulder as much better or better than before the operation, with 68% excellent. There were no statistically significant differences between outcome at 12 and 24 months follow up, however, some further improvements were seen in almost all shoulders with time. No differences were observed between primary and revision cases. No lucencies, subsidence, stress-shielding, glenoid notching or implant loosening were evident radiographically at 2-year follow up. 2 cases had postoperative complications and were revised.

rTSA can be used with good results and high satisfaction rates in patients aged 65 or younger. A short metaphyseal implant preserves more bone for future further surgeries if needed. Good clinical and radiological results are maintained over time.