"For younger patients with severe damage to the rotator cuff muscles a reverse shoulder replacement provides lasting improvement in shoulder function according to a study in The Journal of Bone  Joint Surgery httpjbjs.org. The journal is published in partnership with Wolters Kluwer http In the absence of treatment alternatives reverse total shoulder arthroplasty RTSA is a justifiable treatment for patients with a massive irreparable rotator cuff tear before the age of  according to the report by Christian Gerber MD of the University of Zurich and colleagues. Despite a substantial risk of complications most patients are satisfied with the outcomes of RTSA at followups of a decade or longer. Stable LongTerm Results of RTSA in Patients Younger than   The researchers analyzed the longterm outcomes of RTSA in  patients average age  years. All had massive irreparable tears of the rotator cuff muscles causing shoulder pseudoparalysiswith little no ability to lift the arm. This group of patients typically gets limited benefit from shoulder replacement with conventional implants which rely on the rotator cuff muscles to provide shoulder movement. The RTSA techniqueusing an implant in which the natural locations of the shoulder ball and socket are reverseduses other muscles to move the shoulder providing an alternative when the rotator cuff is severely damaged or destroyed. When first introduced RTSA was performed mainly in elderly patients who placed low demands on the shoulder. With refinements in technique and components in more recent years the procedure has been used in younger more active patients. But there are concerns about how well the results of RTSA will hold up over time in this group of patients. The new study focused on longterm outcomes of RTSA in patients under age . The patients underwent followup examination between eight and  years after surgery average . years. Three patients had RTSA in both shoulders for a total of  procedures. Compared to their preoperative status most patients had substantial longterm improvement after RTSA. The average Constant scorea standard assessment accounting for shoulder motion strength daily activities and painat the time of finalfollowup improved from  to  out of a possible . Patients ratings of subjective shoulder value improved from  percent to  percent compared to  percent for a normal shoulder. Shoulder movement and strength increased while pain decreased. The improvement was similar for patients with and without prior shoulder surgery. However complications occurred in  percent of the shoulders. Further surgery was required in six shoulders in two cases the RTSA procedure was considered a failure. When complications occurred longterm shoulder functioning was not as good but even with the high complication rate  percent of patients rated their satisfaction level as excellent or good.  The results alleviate concerns that the clinical benefits of RTSA might not hold up over time in younger more active patients. Despite its high complication rate Dr. Gerber and colleagues conclude that RTSA provides substantial and lasting improvement in shoulder function and pain in a group of patients with limited treatment options. Click here to read Reverse Total Shoulder Arthroplasty for Massive Irreparable Rotator Cuff Tears Before the Age of  Years LongTerm Results. httpjournals.lww.comjbjsjournalAbstractReverse_Total_Shoulder_Arthroplasty_for_Massive..aspxPRIDJBJS_PR_ Article DOI .JBJS.. About The Journal of Bone  Joint Surgery  The Journal of Bone  Joint Surgery httpjbjs.org JBJS has been the most valued source of information for orthopaedic surgeons and researchers for over  years and is the gold standard in peerreviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide The Journal publishes evidencebased research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do from the science of the content published to the customer service we provide. JBJS is an independent nonprofit journal. About Wolters Kluwer  Wolters Kluwer N.V. AEX WKL is a global leader in information services and solutions for professionals in the health tax and accounting risk and compliance finance and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services. Wolters Kluwer reported  annual revenues of . billion. The company headquartered in Alphen aan den Rijn the Netherlands serves customers in over  countries maintains operations in over  countries and employs  people worldwide. 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