Reverse shoulder arthroplasty in older patients: is it worth it? A subjective functional outcome and quality of life survey

BACKGROUND: Reverse shoulder arthroplasty (RSA) use has largely spread in the last decade. Doubts still exist, however, about its use in the elder population, because of high risk of complications and possibly limited cost-efficiency of the procedure. AIMS: Our work was aimed at defining the subjective outcome, complication and satisfaction rate, and perceived recovery of individual autonomy and quality of life after RSA, in a cohort of patients 79 or more years old at the time of surgery. METHODS: Between 2007 and 2012, 52 patients 79 years old or older received a RSA. In the setting of this study, 27 patients (31 shoulders) were available for clinical evaluation. The ASES score was used for subjective outcome evaluation, while the health-related quality of life was studied with the SF-12 form. An ad hoc questionnaire was used in order to evaluate the satisfaction rate and the recovery in individual autonomy. RESULTS: At 59,3 months mean follow-up, only one patient required revision due to periprosthetic fracture. ASES score attested at 78.2, and SF-12 scores showed values similar to the general age-matched population. Sensible improvement in perceived quality of life was described by 24 patients. When present, comorbidities were associated with lower results. DISCUSSION: RSA outcomes in the elderly are good in terms of function, satisfaction and quality of life recovery. Complications appear primarily linked to age-related conditions and comorbidities show critical association with lower results. CONCLUSIONS: Our study confirms that RSA represents a useful solution for end-stage shoulder disease also in the advanced age population.