ASSESSING THE LONG-TERM OUTCOMES OF REVERSE SHOULDER ARTHROPLASTY IN ELDERLY PATIENTS WITH ROTATOR CUFF ARTHROPATHY

Abstract

Background: Reverse shoulder arthroplasty (RTSA) has become a widely used surgical intervention for elderly patients with rotator cuff arthropathy. It offers significant improvements in pain relief and shoulder function, especially for those who previously had limited options. However, the long-term outcomes, including complications, patient satisfaction, and prosthesis durability, remain subjects of ongoing research and debate.
Objectives: This review aims to evaluate the long-term clinical and functional outcomes of RTSA in elderly patients with rotator cuff arthropathy. Key focus areas include improvements in pain, range of motion, prosthesis longevity, and associated complications over time.
Methodology: A systematic review of 26 peer-reviewed studies published between 2000 and 2024 was conducted, utilizing databases such as PubMed, Scopus, and MEDLINE. Studies were selected based on their focus on RTSA outcomes in patients aged 65 years or older with a minimum follow-up of five years. The evaluation centered on functional scores (e.g., ASES and Constant scores), range of motion, survivorship data, and reported complications.
Results: The majority of studies report significant improvements in pain and shoulder function, with mean gains of 35–50 points in functional outcome scores. Prosthesis survivorship consistently exceeded 85% at 10 years, although rates of complications such as scapular notching, glenoid component loosening, and deltoid fatigue were noted. Patient satisfaction was high, particularly when preoperative expectations were carefully managed. Factors such as preexisting comorbidities, glenoid bone loss, and improper implant positioning influenced outcomes.
Conclusion: RTSA demonstrates robust long-term efficacy in improving pain and functional outcomes for elderly patients with rotator cuff arthropathy. Despite these successes, complications remain a challenge and underscore the need for optimized surgical techniques and enhanced prosthesis designs. Future research should focus on mitigating complications and evaluating newer implant technologies.