Low complication rate for RSA observed in patients aged older than 80 years

Robert Z. Tashjian, MD

Reverse shoulder arthroplasty has been shown to reliably improve pain and shoulder function in patients with rotator cuff arthropathy. A frequent question to shoulder surgeons from patients is, “Am I too old for the operation?” The current study attempts to address that question. The authors clearly show that reverse shoulder arthroplasty can be safely and reliably performed in elderly patients older than the age of 80 years with improvement in function comparable to younger age patients. Increased complication and revision rates primarily due to fracture must be considered in decision-making process as high-risk fall patients or those with severe osteoporosis should be counseled about the elevated risks of fracture. These data will allow improved patient-surgeon decision making regarding the most effective and safest methods of treatment of rotator cuff arthropathy in this elderly patient cohort.

Paul J. Cagle, MD

How to treat arthritis in very elderly patients can be a concerning decision to make, but the authors of this article take on this difficult question and provide helpful data. By examining a group of patients older than 80 years old with both degenerative traumatic etiologies, an improvement in standardized outcome scores and function was appreciated following reverse total shoulder replacement. Although the rate of surgical complication was 30%, the rate of medical complication and mortality was relatively low. Thus, what I take away from this paper is further support that arthroplasty can be utilized to treat arthritis in the elderly population.