Comprehensive Survival Analysis of Reverse Shoulder Arthroplasty: Do Gender, Age, and Surgical Indication Influence Prosthesis Survivorship?

Abstract

Aim: The parameters such as age, gender, and indication for surgery would have a significant influence on the survival of reverse shoulder arthroplasty (RSA). In this context, we aimed to determine how long patients survive after primary and revision RSA procedures and how factors like sex, age, and different reasons for surgery affect survival in a similar group of patients treated by the same surgeon. Methods: This study presents a retrospective analysis of prospectively collected data from 376 patients who underwent RSA surgery between April 2014 and February 2023 in a tertiary university hospital that serves as a referral center for shoulder disorders. Complication and revision rates were assessed, and survivorship analysis was performed using Kaplan-Meier survival plots in different groups according to gender, age, and indication. Results: Forty-six complications were observed in the study population, and 35 (76.1%) of them needed revision surgery. Ten-year revision-free survival was significantly lower in revision RSA compared to primary RSA cases (75.0% vs. 88.7%). Gender did not have a significant influence on complication rates, and survival probabilities were comparable between male and female patients. Younger patients (<60 years) had a higher complication rate and the lowest revision-free survival at 10 years (75.6%). According to the indication, revision RSA for failed arthroplasty and RSA for infection sequelae led to the worst 10-year revision-free survival rates (75.0% and 62.2%, respectively). Conclusion: RSA showed satisfactory survivorship at 10 years, reaching up to almost 90% in the overall population. Age and indication showed significant influence on the survival of RSA, with lower survival probability and a higher complication rate in younger patients.