Minimum 10-year survivorship and risk factors for failure following reverse total shoulder arthroplasty.

BACKGROUND: Prior studies have explored risk factors for short- and mid-term failure following reverse total shoulder arthroplasty (RTSA), but data characterizing factors associated with long-term survivorship remain limited.

METHODS: A retrospective cohort study using the PearlDiver Mariner database identified patients who underwent RTSA from 2010 to 2013 with a recorded healthcare claim at least 10 years after the index procedure. Failure was defined as revision prior to final follow-up. Kaplan-Meier survival analysis estimated survivorship at two, five, and 10 years, and multivariate logistic regression identified risk factors for failure.

RESULTS: Of 5269 patients identified, 273 (5.2%) underwent revision surgery. One-, five-, and 10-year survival rates were 97.8%, 95.7%, and 95.0%, respectively. Mean time to revision was 2.5 years (median 1.4 years). In multivariate analysis, each additional year of age was associated with approximately 4% lower odds of revision (odds ratio (OR): 0.96), indicating higher odds among younger patients. Male sex (OR: 1.58), prior rotator cuff repair (OR: 1.49), and a primary diagnosis of glenohumeral osteoarthritis (OR: 1.34) were significantly associated with increased odds of reoperation.

CONCLUSION: RTSA demonstrates excellent 10-year survivorship with a low revision rate. Male sex, younger age, prior rotator cuff repair, and glenohumeral osteoarthritis were independent risk factors for long-term failure.

LEVEL OF EVIDENCE: Level IV.