Study: Improved outcomes seen with RSA at 10-year follow-up
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Reverse shoulder arthroplasty was linked with improved patient-reported outcomes, pain scores and patient satisfaction at 10-year follow-up, according to results presented at the virtual American Shoulder and Elbow Surgeons Annual Meeting.
“This is the largest American cohort of RSAs that we are aware of with a minimum of 10-year follow-up,” Brent J. Morris, MD, said.
Morris and colleagues studied patient satisfaction and outcomes of RSA with a minimum of 10-year follow-up. They used a prospective shoulder arthroplasty registry, which dates to 2004, to identify 383 eligible patients who received either primary or revision RSA. Of the living 201 eligible patients, 75 patients had a minimum of 10-year follow-up data.
Average follow-up was 11.7 years. Average age at index RSA was 65.4 years, and 60% of patients were female. Primary RSA was done in 56 patients, and 19 patients were in the revision RSA group. The most common indication was rotator cuff tear arthroplasty in 44 patients. Researchers used standardized surgical technique, rehabilitation and follow-up protocols.
Primary outcomes were patient-reported outcomes (SANE score), pain scores and patient satisfaction. Secondary outcomes were implant survival, which was revision for any reason to be considered a failure, and willingness to have RSA again.
Researchers found seven patients who required a revision, leaving a 90.7% implant survival at 10 years. The average SANE score was 73.2±28.7 and the average pain score 2.2±2.8. Overall, 59 patients were satisfied or very satisfied at final follow-up and 94% of patients said they would have the procedure again.
Morris said limitations of the study were midterm results were not compared to long-term results and significant loss to follow-up.
“Patient-reported outcomes, pain and implant survivability were reported, but no long-term radiographic variables or complications were presented in our current abstract form,” he said.
He also said it the surgeries were performed by single “master surgeon,” so results may not be generalizable.
Follow-up is ongoing and researchers will stratify the results based on primary vs. revisions RSA cases, Morris said.
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Christopher Kilian, MD
Brent J. Morris, MD, and colleagues should be commended on an excellent abstract, reporting patient outcomes 10 years status post reverse shoulder arthroplasty. This is an exceptionally important topic, with a relative paucity of literature to help guide shoulder surgeons. Perhaps the most frequently asked question before shoulder replacement remains: How long will this replacement last? As the modern reverse shoulder replacement evolves and long-term data becomes available, this question is thankfully being answered. With 94% of patients stating they would have the procedure again and a 90% survival rate at 10 years, surgeons certainly have more data to provide patients. This data will allow patients to make a more informed decision about their shoulder and the expected outcome. As these patients continue to age, I hope Morris and his colleagues continue to follow this cohort, allowing an even more comprehensive understanding of the reverse shoulder replacement and the breadth of the patient experience.
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Morris BJ, et al. Paper 5. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 2-3, 2020 (virtual meeting).
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