Functional and radiographic outcomes of octogenarians undergoing primary reverse total shoulder arthroplasty: a retrospective study

Abstract

BackgroundAs the demand for primary reverse total shoulder arthroplasty (RTSA) increases due to an aging population and expanding indications, it is crucial to understand the effects of the age on outcomes, particularly in patients 80 years or older. The purpose of this study was to determine postoperative patient-reported outcomes and evaluate postoperative imaging of octogenarian patients (≥80 year old) who underwent primary RTSA with a minimum 12-month follow-up. MethodsIn this retrospective case series, all consecutive patients aged 80 years or older who underwent primary RTSA at a tertiary health-care system were included from April 2012 to January 2022. Patient demographic and preoperative comorbidity data were collected, and the corresponding standard comorbidity indices were determined for each patient. Primary outcomes included postoperative patient-reported functional outcomes, while the secondary outcomes were adverse radiographic findings, mortality, and 90-day postoperative complications. Statistical analysis included descriptive analyses and a Wilcoxon Signed-Rank test for comparisons. A P < .05 was considered to be statistically significant. ResultsA total of 59 patients were included in the analysis, with a mean age of 84.21 ± 3.24 years and 39 (66.1%) female patients. All patient-reported outcome measures significantly improved postoperatively, including the Single Assessment Numeric Evaluation and American Shoulder and Elbow Surgeons scores, the Visual Analog Scale, and range of motion. The most common adverse radiographic outcome was scapular notching (27.1%), followed by acromial stress fractures (5.1%). Eight (13.6%) complications were observed, requiring four revision surgeries. ConclusionIn conclusion, RTSA leads to significant improvements in patient-reported outcomes with an acceptable rate of adverse radiographic outcomes in patients aged 80 years or older. Despite the potential for increased risk of adverse events in the elderly population, our study did not find an increase in complications within this age group when compared to rates previously reported in literature. Our findings suggest that RTSA is a safe and effective option in octogenarian patients.