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Reverse total shoulder replacement outcomes: 6 key notes for 12.5 year follow-ups

A new study published in the Journal of Bone and Joint Surgery examines long term outcomes for reverse total shoulder replacement.

The article re-examines clinical outcomes from a previous report. The original report included outcomes for 186 patients who underwent 191 reverse total shoulder replacements. The updated study followed the patients for 150 months, as opposed to the 40 months of original follow-up. There were 84 patients with 87 prostheses that were available for 150 months, and radiographic assessments available for 64 patients.

The researchers found:

1. The average absolute and relative constant scores and standard deviations decreased significantly compared to the scores two years after surgery.

2. At 150 months after surgery, the average constant scores were 55±16 and the average relative constant scores were 86±26 points.

3. More than half — 73 percent — of the shoulders reported scapular notching.

4. Complications occurred in 29 percent of the shoulders and 10 percent of those cases happened two years or more after surgery.

5. There were 16 original patients who underwent revision procedures.

6. The 10-year survival rate for the prosthetic was 93 percent, with revision as the end point.

"Despite a high arthroplasty survival rate and good long-term clinical results, RTSA outcomes showed deterioration when compared with medium-term results," concluded the study authors. "The cause of this decrease is probably related to patient aging coupled with bone erosion and/or deltoid impairment over time."

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