Sunday, March 30, 2014

Reverse total shoulder outcomes in patients younger than 60 years of age.

Clinical outcomes of reverse total shoulder arthroplasty in patients aged younger than 60 years.

The authors evaluated 36 shoulders (mean age, 54 years) at a mean follow-up of 2.8 years (range, 24-48 months).

Of these shoulders, 30 (83%) had previous surgery, averaging 2.5 procedures per patient.

The indications for  RTSA were: failed rotator cuff repair (12), fracture sequelae (11), failed arthroplasty (5), instability sequelae (4), cuff tear arthropathy (CTA) (4), and rheumatoid arthritis (2). 

Nine patients (25.0%) had ASES scores below 50 and were considered failures. Six shoulders had complications, five of which required revision: instability (three cases), periprosthetic fracture (one case), and traumatic acromial fracture (one case, treated without surgery).

Comment: These patients had at least three major risk factors for adverse outcomes: young patient age, complex diagnoses, and prior surgery.  It is also likely that the surgeon experience was less than in the prior post. The annualized complication rate was 6%, about twice that reported in the previous post with older patients, simpler diagnoses, and fewer revision surgeries.

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