Reverse total shoulder arthroplasty may help elderly without arthritis

Reverse total shoulder arthroplasty may help elderly without arthritis

The use of reverse total shoulder arthroplasty (RTSA) may be a beneficial therapy in patients older than 60 years with chronic rotator cuff tears (RCT) without glenohumeral arthritis, suggest researchers at Boston University College of Medicine.

The study evaluated data from a retrospective review between 2007 and 2015 of patients who were diagnosed without chronic shoulder arthritis. The national trends for surgical management of chronic rotator cuff tear in patients without glenohumeral arthritis were observed.

The team identified 428,651 patients who had chronic rotator cuff tear without arthritis, with 84.9% received nonoperative treatment; 12.5% received rotator cuff repair (RCR); and 2.6% underwent RTSA.

Patients between the ages of 60 and 79 years had a 70.8% rate of surgical intervention, with 69.2% undergoing RCR and 78.4% receiving RTSA, the researchers wrote. There was a three-fold increase in RTSA use noted in patients 60 years or older compared with patients younger than 60 years.

The overall rate of revision at 2 years was 13% for patients between 60 and 79 years of age who underwent RCR compared to patients of the same age who underwent RTSA (3.7%), Vora and colleagues wrote. There were consistent revision rates over time after RCR (9.3% to 13%), while revision rates for RTSA reduced significantly (12.1% to 2.2%).

The findings support the effectiveness of RTSA in treating older patients who have chronic irreparable RCT without arthritis, as measured by a wide number of outcomes, including pain, active forward flexion, and to a lesser extent, external rotation motion, wrote the researchers.