Reverse shoulder arthroplasty (RSA) is increasingly used to treat painful cuff tear arthropathy (CTA), shoulder osteoarthritis (OA), and proximal humeral fractures (PHF). This non-anatomical procedure, featuring a convex glenoid and concave humeral component, has shown promising short (1-2 years) - to mid-term (2-5 years) clinical results. However, RSA, like any major surgery, carries significant risks, including infection and instability, which may lead to revisions. The demand for RSA is expected to rise with the aging population, particularly for CTA/OA and PHF cases. This study aims to analyze factors influencing the clinical outcomes of RSA and the post-surgical risk of revision.

Numbers of RSA surgeries were found to have increased in Scandinavia shoulder registry for the treatment of glenohumeral OA and CTA. The overall mid-term risk of revision was low (5%), and the main reason for early revision was infection. Men had significantly increased risk of revision compared to women 3.8 times higher. In patients with RSA performed for acute proximal humerus fracture, the short-term risk of revision was low (2%), and the main reason for revision was instability. Patients treated with RSA at Turku University Hospital between 2007 and 2019 were analysed retrospectively. No direct correlation was found between radiological parameters and clinical results. Glenoid bone grafting in conjuction with RSA is a safe and reliable option to restore the glenoid bone stock and secure the construct in short term follow-up. There was no significant difference in component survival between auto- and allograft bone grafting techniques.

These studies are important for clinical practice as they provide valuable insights that can guide surgical decisions, improve patient selection, and inform patients with the potential risks and also realistic expectations related to the procedure. By understanding the factors influencing RSA outcomes, clinicians can enhance patient care, optimize surgical planning, and reduce revision rates, ultimately leading to better long-term (5-10 years) results.