Reverse Total Shoulder Arthroplasty in Patients Who Exceeded Their Life-expectancy: a Retrospective Study

Reverse total shoulder arthroplasty (RTSA) has become an established treatment for cuff arthropathy, severe osteoarthritis and in certain fracture cases. Due to the increasingly aging population, patients who have already exceeded their life-expectancy pose a significant challenge to the shoulder surgeon. Therefore, we wanted to investigate patient demographics, hospital stay length, complication rate functional outcome, patient reported outcome scores and mortality retrospectively for patients, who were older than 83 years at time of implantation of a RTSA.

Study Overview

• Status: Completed
• Conditions: Reverse Total Shoulder Arthroplasty
• Intervention / Treatment: Procedure: Reverse Total Shoulder Arthroplasty (RTSA)

Detailed Description

This is a retrospective single institution study. All patients older than 83 years who received a reverse shoulder arthroplasty from 2008 until 2019 are included. Elective cases are compared to fracture cases (patient demographics, length of hospital stay, complication rate, functional outcome, patient reported outcome scores and mortality).

• Study Type: Observational
• Enrollment (Actual): 110

Contacts and Locations

Study Locations

• Switzerland
  • Solothurn, Switzerland, 4500
    • Bürgerspital Solothurn

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 83 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients who have already exceeded their life-expectancy (83 years in Switzerland)

Description

Inclusion Criteria:

• Patients older than 83 years at time of surgery
• Patients who received a reverse total shoulder arthroplasty

Exclusion Criteria:

• Patients younger than 83 years at time of surgery

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Elective cases; Patients, who received a RTSA for degenerative reasons like cuff arthropathy or osteoarthritis	Procedure: Reverse Total Shoulder Arthroplasty (RTSA); Implantation of a Reverse Total Shoulder Arthroplasty
Fracture cases; Patients, who received a RTSA for a proximal humerus fracture	Procedure: Reverse Total Shoulder Arthroplasty (RTSA); Implantation of a Reverse Total Shoulder Arthroplasty

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient reported outcome score: ASES	American Shoulder and Elbow Society (ASES) Score	until august 2020
Complication rate	postoperative complications requiring surgical intervention	until august 2020
Quality adjusted life year (QALY)	The quality adjusted life year (QALY) ) is a well-established indicator of the life quality for the remaining years and was calculated as the years of life following the operation, multiplied by the utility value, for the current study, defined as the postoperative American Shoulder and Elbow Surgeons Shoulder Score (ASES) score (0-1 points) at last follow-up.	until august 2020
Mortality	Survivership	until august 2020
Patient reported outcome score: QuickDASH	Quick Disabilities of the arm, shoulder and hand (DASH) Score,	until august 2020
Patient reported outcome score: VAS	Visual analog score (VAS)	until august 2020

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient demographics	male/female ratio, age, BMI, ASA (American Society of Anesthesiologists) classification, hospital stay length, range of motion	at time of surgery

Collaborators and Investigators

• Sponsor: Bürgerspital Solothurn
• Investigators: Principal Investigator: Mai Lan Dao Trong, MD, Bürgerspital Solothurn

Study record dates

Study Major Dates

• Study Start (Actual): March 24, 2019
• Primary Completion (Actual): August 4, 2020
• Study Completion (Actual): December 21, 2020

Study Registration Dates

• First Submitted: March 16, 2021
• First Submitted That Met QC Criteria: March 17, 2021
• First Posted (Actual): March 19, 2021

Study Record Updates

• Last Update Posted (Actual): March 19, 2021
• Last Update Submitted That Met QC Criteria: March 17, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: complications; elderly; outcome; reverse total shoulder arthroplasty; RTSA; proximal humerus fracture; cuff arthropathy
• Other Study ID Numbers: RTSA in very old patients

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No