Reverse shoulder arthroplasty in the young patient: A review

Reverse Shoulder Arthroplasty (RSA) is typically reserved for older, infirm patients presenting with irreparable rotator cuff tear arthropathy and proximal humerus fractures. Over the past few decades, RSA has become increasingly popular and now accounts for a significant percentage of shoulder arthroplasty volume in the United States. RSA, which was traditionally taught mainly for patients over 70 years of age, is now becoming more common in younger patients. There is some variability in the definition of a young patient, but it is typically defined as a patient younger than 65 years. A patient’s history will help frame the discussion and provide the surgeon with a list of potential differential diagnoses. A physical examination will help test and confirm the validity of these diagnoses as well as help determine the cause and severity of the illness. Emphasis should be placed on how illness affects a patient’s life. Physical examination is another tool used to confirm the hypothesis of the surgeon and patient’s story. Imaging can further confirm this diagnosis. Radiographs are used to provide an initial impression. Radiographs should be studied chronologically as a means to gauge symptom severity and progression and to correlate with the patient’s story. Indications for RSA include osteoarthritis, revision arthroplasty, and rotator cuff arthropathy. Complications for RSA in young patients ranges from 16.5% to 39.1%. Some of the major complications associated with RSA include infection and instability. Outcomes for RSA are good with American Shoulder and Elbow Surgeons Shoulder Score improvements and increased shoulder range of motion