Background: Reverse total shoulder arthroplasty (RTSA) has been indicated primarily for patients aged older than 65 years with symptomatic rotator cuff deficiency, poor function, and pain. However, conditions that benefit from RTSA are not restricted to an elderly population. This study evaluates a consecutive series of RTSA patients aged younger than 50 years.
Methods: We evaluated 11 patients (mean age, 52.4 years) at a mean follow-up of 3.3 years (range, 4.8–1.5 years). Of these shoulders, 8% (72.7%) had previous surgery; the preoperative conditions compelling RTSA were as follows: failed rotator cuff repair (2), fracture sequelae (3), failed hemiarthroplasty (3). Follow-up examinations included range-of-motion and strength testing, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. Preoperative and postoperative radiographs were reviewed for component loosening and scapular notching.
Results: The ASES score significantly improved from a preoperative mean of 31.1 to a postoperative mean of 69.2%. The mean active elevation improved from 59 to 135°. The normalized postoperative mean Constant score was 58.
Conclusion: RTSA can improve shoulder function in a younger, complex patient population with poor preoperative functional ability. This study’s success rate was 85% at 3.3 years. This is a limited-goals procedure, and longer-term studies are required to determine whether similar results are maintained over time.
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