Younger patients report similar activity levels to older patients after reverse total shoulder arthroplasty

Abstract

Background: Younger patients who have undergone reverse total shoulder arthroplasty (RTSA) are believed to have higher activity levels that place higher stresses across the prosthesis, increasing the risk of failure, but there is little information to support or refute this supposition. The purposes of this study were to define the patient-reported activity levels of patients younger than 65 years and older than 65 years who underwent RTSA and to evaluate any differences between the groups.

Methods: Forty-six patients who underwent primary RTSA answered a questionnaire regarding their activity levels. Data were categorized and tabulated according to pain, range of motion, strength, and activity level (low, medium, and high demand). Statistical analyses were performed using the Fisher exact test, χ(2) test, and independent t test. Differences with P < .05 were considered statistically significant.

Results: Seventeen patients younger than 65 years (mean age, 57.7 years) and 29 patients older than 65 years (mean age, 75.2 years) were included. No significant differences were found for range of motion, strength, or number of activities; 47% of younger patients and 44% of older patients reported high-demand activities (P = .64); 24% of younger patients and 37% of older patients reported medium-demand use (P = .30). Patients younger than 65 years were more likely to require narcotic pain medication (P = .03) and to have disability (P = .0001).

Conclusion: These data provide initial evidence that commonly held concerns about higher activity levels among younger patients placing excessive demands on the RTSA prosthesis may not be as important as currently thought. Rather, patients seem to self-regulate their activities to minimize pain and maximize essential functions after surgery.

Keywords: Reverse total shoulder arthroplasty; activities; older patients; patient-reported; survey; younger patients.