Reverse total shoulder arthroplasty (RTSA) has been established as an effective treatment for patients with rotator cuff deficiency, pain, and poor function; typically, cuff tear arthropathy has been the primary diagnosis. However, other shoulder conditions with a dysfunctional or irreparable rotator cuff and joint injury have been treated with RTSA. Outcomes have been shown to be correlated with the preoperative diagnosis and the indication for surgery. Wal showed that primary arthropathies result in better outcomes than post-traumatic etiologies or revision cases. Furthermore, Frankel and colleagues described the use of RTSA in proximal humeral malunions, Cazeneuve and Cristofari4 reported on outcomes for fracture treatment, and Holcomb described successful use in the rheumatoid population. The reverse shoulder replacement has become a valuable tool for the shoulder surgeon and can be applied to a variety of pathologies.

Traditionally, the majority of RTSAs are performed in an older patient population with low functional demands on their shoulders. However, the conditions that potentially benefit from an RTSA are not restricted to an elderly population. We consider the use of RTSA in patients with symptomatic irreparable rotator cuff deficiency, poor active elevation (<60 ), pain, or joint injury (degenerative joint disease

[DJD], existing implant, or fracture). Few studies in the literature specifically analyze the clinical outcome of RTSA in a younger (<60 years) population. We hypothesize that younger patients will have improvements in function and pain profiles similar to those seen in an older patient population. The purpose of this study is to report the clinical outcomes (range of motion [ROM], strength, patient function) of patients aged younger than 60 years who underwent a primary RTSA. The preoperative clinical conditions that compelled consideration of an RTSA were evaluated, as were the preoperative diagnoses.

Full Article: Clinical outcomes of reverse total shoulder arthroplasty in patients aged younger than 60 years