LAUSR

BACKGROUND While initially indicated for use in older patients, reverse total shoulder arthroplasty (rTSA) is being increasingly used in younger patients. The purpose of this study is to compare the clinical and radiographic outcomes of patients under the age of 60 to those aged 60-79 following primary rTSA. METHODS 154 patients under 60 years old and 1,763 patients aged 60-79 were identified from an international multi-institutional WIRB approved registry with a minimum 2-years follow-up. All patients were evaluated and scored preoperatively and at latest follow-up using 5 outcome scoring metrics and 4 active range of motion (ROM) measurements. RESULTS Patients under 60 were more often male (p = 0.023), had a higher BMI (p = .001), higher rates of previous surgery (57% vs 27%, p <0.001), higher rates of post traumatic arthritis (11% vs 5%, p <0.001) and inflammatory arthropathy (13% vs 4%, p <0.001), and lower rates of rotator cuff tear arthropathy (25% vs 38%, p = 0.006). There were no differences in ROM between the groups but patients under 60 had statistically significant lower function and outcome metric scores, and higher pain scores at latest follow-up. Adverse events rates were similar between the two groups, but patients under age 60 were more likely to require revision (5.2% vs 1.8%, p=0.004). Patients under 60 also had lower satisfaction scores (much better/better 86% vs 92%, p = 0.006). CONCLUSION At a mean follow-up of 47 months, primary rTSA patients under age 60 years had worse clinical outcomes compared to those aged 60-79 years, with lower outcome scores, increased pain, lower function scores and less patient satisfaction. Patients younger than 60 years of age had higher rates of previous surgery, inflammatory arthropathy, and post-traumatic arthritis, while those aged 60-79 had higher rates of rotator cuff tear arthropathy. While complications were similar, younger patients had three times the risk of revision rTSA.