Survival rate and outcomes of reverse total shoulder arthroplasty with a minimum ten-year follow-up using a trabecular metal implant.

Abstract

There are few reports of outcomes after reverse total shoulder arthroplasty (RTSA) with over ten years of follow-up. Further, there is a lack of reports on RTSA with trabecular metal (TM) implants with ten-year follow-up. We aim to assess the ten-year survival and minimum ten-year outcomes of TM-RTSA. All RTSA procedures were performed between October 2007 and July 2013 in a single institution. A consecutive series of 206 RTSAs in 194 patients were included in the Kaplan-Meier survival analysis using revision or removal for any reason as the endpoint. We also investigated the clinical and radiological outcomes at a minimum follow-up of ten years. Out of 206 RTSAs, there were a total of 13 failures. The median time from surgery was 1.6 years (IQR 0.08 to 7.5). The five-year implant survival rate was 94.7% (95% CI 89.9 to 97.2; 102 RTSAs at risk), and the ten-year rate was 90.5% (95% CI 82.9 to 94.8; 62 RTSAs at risk). Minimum ten-year outcomes were available for 60 RTSAs, including 57 with ASES scores and 40 RTSAs with radiographs with a mean follow-up period of 11.3 years. The ASES score was a median pain score of 50 (IQR 45 to 50) and a median functional score of 36.7 (IQR 23.3 to 41.7) on the ipsilateral side. In radiological analyses for 40 RTSAs, scapular notching was observed in 31 RTSAs (77.5%) and classified as grade III or IV, as described by Sirveaux et al, in five RTSAs (12.5%). Glenoid radiolucency was observed in 11 RTSAs (27.5%) and loosening in three RTSAs (7.5%). TM RTSA demonstrated a high ten-year survival rate of 90.5%. Although radiological findings increased over time, clinical outcomes remained favourable.