PMID- 34896251 OWN - NLM STAT- MEDLINE DCOM- 20220523 LR - 20220531 IS - 1532-6500 (Electronic) IS - 1058-2746 (Linking) VI - 31 IP - 6 DP - 2022 Jun TI - Clinical and radiographic outcomes after reverse total shoulder arthroplasty in patients 80 years of age and older. PG - 1137-1142 LID - S1058-2746(21)00826-0 [pii] LID - 10.1016/j.jse.2021.10.044 [doi] AB - BACKGROUND: Previous studies have found less favorable outcomes for patients aged 80 years and older after primary reverse total shoulder arthroplasty (rTSA). However, they are based on small sample sizes with no control group for comparison. The purpose of this study is to compare the clinical, functional, and radiographic outcomes after primary rTSA in patients aged 80 years and older with a younger cohort of patients aged 60-79 years. METHODS: Patients undergoing primary rTSA between 2004 and 2018 were identified within a multi-institutional database with a minimum of 2 years of follow-up. All patients received the same platform prosthesis. Patients were divided into 2 groups based on age: 80 years and older (n = 369) and 60-79 years (n = 1764). Statistical analyses were performed to compare the 2 age cohorts based on pre- and postoperative function and range of motion (ROM) scores, adverse event rates, pain scores, and patient satisfaction. RESULTS: Patients aged 80 years and older had lower preoperative functional and ROM scores relative to patients aged 60-79 years. The differences observed in active abduction, active forward elevation, and Constant scores exceed the minimal clinically important difference (MCID). The evaluation of function and ROM at latest follow-up showed that patients in both age cohorts had significant improvements that exceeded both the MCID and substantial clinical benefit, but older patients still scored lower relative to younger patients, with the differences in active abduction and Constant scores exceeding the MCID. Despite the lower scores observed in older patients, both groups report similar satisfaction (93% in older patients vs. 92% in younger patients, P = .379). There were no differences between the 2 age cohorts with regard to humeral radiolucent lines (9.2% vs. 8.7%, P = .765), scapular notching (11.0% vs. 10.3%, P = .727), adverse events (3.5% vs. 3.3%, P = .863), and revisions (0.8% vs. 1.8%, P = .188). CONCLUSIONS: Patients aged 80 years and older can expect significant improvements in function and ROM after primary rTSA, with satisfaction similar to that of patients aged 60-79 years. Patients in both age cohorts have similar rates of adverse events and revisions, and the rates observed in patients 80 years and older are much lower than what has previously been reported in the literature. rTSA in patients age 80 years and older is a beneficial surgery with outcomes similar to those found in younger patients, and age should not be a limiting factor when considering rTSA. CI - Copyright (c) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved. FAU - Boettcher, Marissa L AU - Boettcher ML AD - Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA. FAU - Neel, Garrett B AU - Neel GB AD - Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA. FAU - Reid, Jared J AU - Reid JJ AD - Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA. FAU - Eichinger, Josef K AU - Eichinger JK AD - Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA. FAU - Friedman, Richard J AU - Friedman RJ AD - Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA. Electronic address: friedman@musc.edu. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20211208 PL - United States TA - J Shoulder Elbow Surg JT - Journal of shoulder and elbow surgery JID - 9206499 SB - IM MH - Aged MH - Aged, 80 and over MH - Arthroplasty MH - *Arthroplasty, Replacement, Shoulder MH - Humans MH - Middle Aged MH - Range of Motion, Articular MH - Retrospective Studies MH - *Shoulder Joint/diagnostic imaging/surgery MH - Treatment Outcome OTO - NOTNLM OT - Reverse total shoulder OT - arthroplasty OT - clinical OT - old OT - outcomes OT - patient age OT - radiographic EDAT- 2021/12/14 06:00 MHDA- 2022/05/24 06:00 CRDT- 2021/12/13 12:16 PHST- 2021/08/18 00:00 [received] PHST- 2021/10/25 00:00 [revised] PHST- 2021/10/30 00:00 [accepted] PHST- 2021/12/14 06:00 [pubmed] PHST- 2022/05/24 06:00 [medline] PHST- 2021/12/13 12:16 [entrez] AID - S1058-2746(21)00826-0 [pii] AID - 10.1016/j.jse.2021.10.044 [doi] PST - ppublish SO - J Shoulder Elbow Surg. 2022 Jun;31(6):1137-1142. doi: 10.1016/j.jse.2021.10.044. Epub 2021 Dec 8.