JSES reviews, reports, and techniques · 2026
Primary reverse total shoulder arthroplasty in patients aged ≤65 years: a systematic review and meta-analysis.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stamiris Dimitrios, Stamiris Stavros, Solovos Evangelos M, Sarris Ioannis, Arealis Georgios
Аннотация
BACKGROUND: Reverse total shoulder arthroplasty (rTSA), once reserved for elderly low-demand patients, is increasingly used in younger adults despite concerns regarding complication rates and longevity. This systematic review and meta-analysis evaluate contemporary evidence on primary rTSA in patients aged ≤65 years.
METHODS: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, PubMed, Scopus, and CENTRAL databases were searched to October 2025. Studies reporting outcomes of primary rTSA in patients ≤65 years with ≥2 years of follow-up were included. Data on indications, functional outcomes, range of motion (ROM), patient-reported outcome measures (PROMs), complications, revisions, and implant survival were recorded and synthesized. Subgroup analyses based on patients' age and comparisons with older rTSA cohorts were also performed.
RESULTS: Thirteen studies met our inclusion criteria. Cuff tear arthropathy (27.29%), massive cuff tears (23.39%), and glenohumeral osteoarthritis (22.34%) accounted for most indications. rTSA resulted in significant improvements in ROM and all major PROMs. The overall complication rate was 14.23%, and the revision rate was 2.92%, with instability and infection responsible for 64.2% of revisions. Mid- to long-term implant survival exceeded 85%. When compared with older patients, younger adults demonstrated equivalent ROM outcomes. Concerning PROMs younger patients demonstrated inferior American Shoulder and Elbow Surgeons (mean difference [MD] = -6.43, P = .01), visual analog scale (MD = 0.93, P < .01), Constant score (MD = -4.98, P < .01), University of California Los Angeles (MD = -2.07, P < .01), and Shoulder Pain and Disability Index (MD = 13.56, P < .01), whereas Simple Shoulder Test (MD = -0.7, P = .19) did not differ between the 2 groups. Moreover, younger patients presented a higher revision risk (risk ratio [RR] = 2.21, P < .01).
CONCLUSION: Primary rTSA provides substantial and predictable improvements in pain and shoulder function among young adults, with acceptable early- to mid-term durability. Nevertheless, younger age remains associated with higher revision risk and modestly lower subjective outcomes, likely reflecting greater functional demands and post-operative expectations. These findings highlight the importance of nuanced surgical decision-making and patient counseling as rTSA use continues to expand in this demographic.
METHODS: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, PubMed, Scopus, and CENTRAL databases were searched to October 2025. Studies reporting outcomes of primary rTSA in patients ≤65 years with ≥2 years of follow-up were included. Data on indications, functional outcomes, range of motion (ROM), patient-reported outcome measures (PROMs), complications, revisions, and implant survival were recorded and synthesized. Subgroup analyses based on patients' age and comparisons with older rTSA cohorts were also performed.
RESULTS: Thirteen studies met our inclusion criteria. Cuff tear arthropathy (27.29%), massive cuff tears (23.39%), and glenohumeral osteoarthritis (22.34%) accounted for most indications. rTSA resulted in significant improvements in ROM and all major PROMs. The overall complication rate was 14.23%, and the revision rate was 2.92%, with instability and infection responsible for 64.2% of revisions. Mid- to long-term implant survival exceeded 85%. When compared with older patients, younger adults demonstrated equivalent ROM outcomes. Concerning PROMs younger patients demonstrated inferior American Shoulder and Elbow Surgeons (mean difference [MD] = -6.43, P = .01), visual analog scale (MD = 0.93, P < .01), Constant score (MD = -4.98, P < .01), University of California Los Angeles (MD = -2.07, P < .01), and Shoulder Pain and Disability Index (MD = 13.56, P < .01), whereas Simple Shoulder Test (MD = -0.7, P = .19) did not differ between the 2 groups. Moreover, younger patients presented a higher revision risk (risk ratio [RR] = 2.21, P < .01).
CONCLUSION: Primary rTSA provides substantial and predictable improvements in pain and shoulder function among young adults, with acceptable early- to mid-term durability. Nevertheless, younger age remains associated with higher revision risk and modestly lower subjective outcomes, likely reflecting greater functional demands and post-operative expectations. These findings highlight the importance of nuanced surgical decision-making and patient counseling as rTSA use continues to expand in this demographic.