Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Sep 11;3(3):162-167.
doi: 10.1016/j.jses.2019.06.003. eCollection 2019 Oct.

Reverse shoulder arthroplasty in patients aged 65 years or younger: a systematic review of the literature

Mikaël Chelli  1 , Lucas Lo Cunsolo  1 , Marc-Olivier Gauci  1 , Jean-François Gonzalez  1 , Peter Domos  2 , Nicolas Bronsard  1 , Pascal Boileau  1
Affiliations
Review

Reverse shoulder arthroplasty in patients aged 65 years or younger: a systematic review of the literature

Mikaël Chelli et al. JSES Open Access. .

Abstract

Background: Reverse shoulder arthroplasty (RSA) is offered to young patients with a failed previous arthroplasty or a cuff-deficient shoulder, but the overall results are still uncertain. We conducted a systematic review of the literature to report the midterm outcomes and complications of RSA in patients younger than 65 years.

Methods: A search of the MEDLINE and Cochrane electronic databases identified clinical studies reporting the results, at a minimum 2-year follow-up, of patients younger than 65 years treated with an RSA. The methodologic quality was assessed with the Methodological Index for Non-Randomized Studies score by 2 independent reviewers. Complications, reoperations, range of motion, functional scores, and radiologic outcomes were analyzed.

Results: Eight articles were included, with a total of 417 patients. The mean age at surgery was 56 years (range, 21-65 years). RSA was used as a primary arthroplasty in 79% of cases and revision of a failed arthroplasty in 21%. In primary cases, the indications were cuff tear arthropathy and/or massive irreparable cuff tear in 72% of cases. The overall complication rate was 17% (range, 7%-38%), with the most common complications being instability (5%) and infection (4%). The reintervention rate was 10% at 4 years, with implant revision in 7% of cases. The mean weighted American Shoulder and Elbow Surgeons score, active forward elevation, and external rotation were 64 points, 121°, and 29°, respectively.

Conclusions: RSA provides reliable clinical improvements in patients younger than 65 years with a cuff-deficient shoulder or failed arthroplasty. The complication and revision rates are comparable to those in older patients.

Keywords: Reverse shoulder arthroplasty; complications; functional outcomes; revision arthroplasty; systematic review; young population.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of included studies. FU, follow-up.
See this image and copyright information in PMC

References

    1. Ammitzboell M., Baram A., Brorson S., Olsen B.S., Rasmussen J.V. Poor patient-reported outcome after shoulder replacement in young patients with cuff-tear arthropathy: a matched-pair analysis from the Danish Shoulder Arthroplasty Registry. Acta Orthop. 2019;90:119–122. doi: 10.1080/17453674.2018.1563855. - DOI - PMC - PubMed
    1. Black E.M., Roberts S.M., Siegel E., Yannopoulos P., Higgins L.D., Warner J.J.P. Reverse shoulder arthroplasty as salvage for failed prior arthroplasty in patients 65 years of age or younger. J Shoulder Elbow Surg. 2014;23:1036–1042. doi: 10.1016/j.jse.2014.02.019. - DOI - PubMed
    1. Boileau P., Trojani C., Chuinard C., Lehuec J.-C., Walch G. Proximal humerus fracture sequelae: impact of a new radiographic classification on arthroplasty. Clin Orthop Relat Res. 2006;442:121–130. doi: 10.1097/01.blo.0000195679.87258.6e. - DOI - PubMed
    1. Boileau P., Watkinson D.J., Hatzidakis A.M., Balg F. Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg. 2005;14:S147–S161. doi: 10.1016/j.jse.2004.10.006. - DOI - PubMed
    1. Booth A., Clarke M., Dooley G., Ghersi D., Moher D., Petticrew M. The nuts and bolts of PROSPERO: an international prospective register of systematic reviews. Syst Rev. 2012;1:2. doi: 10.1186/2046-4053-1-2. - DOI - PMC - PubMed

LinkOut - more resources