Summary

This restrospective review of 50 patients demonstrates excellent funtional results without or without pseudoparalysis in patients over 80 years old.

Abstract

Background

Reverse shoulder arthroplasty is an accepted procedure for the treatment of rotator cuff arthropathy. Original concerns about the longevity of the prosthesis madated that it be used selectively. As indications have broadened, and followup improved, reverse shoulder replacement may be suitable for multiple indications. To date, limited information exists about how the reverse performs in an older population with or without rotator cuff dysfunction.

Methods

A retrospective review of all patients over the age of 80 from a single surgeon who received a reverse replacement were identified. The results of 25 patients with cuff tear arthropathy and pseudoparalysis were compared to 25 patients who had preserved forward elevation.

Results

For the 25 patients with pseudoparalysis the average age at implantation was 82 (80-86) with a mean follow-up of 2.6 years (1-6 years). Average forward flexion improved from 60 (20-85) degrees to 131 degrees (90-160), SSV from 30% to 90%, and the VAS decreased from a mean of 7.5 to 1.2. For the patients with preserved forward elevation, the average age at implantation was 81 (80-83) with a mean follow-up of 3 years (1-7 years); the average forward flexion improved from 117 (90-160) to 135 (100-160); SSV also improved from 30% to 90%, and VAS declined from 7.5 to 1. No device related complications occurred and all patients were very satisfied with their surgeries.

Conclusions

Reverse shoulder replacement is a viable option for patients over the age of 80 years old with or without pseudoparalysis. Results were equivalent for both groups. Our current practice is to recommend reverse shoulder replacement for all patients over the age of 80 who are candidates for shoulder arthroplasty regardless of rotator cuff status.