Effect of Age on Outcomes of Shoulder Arthroplasty.

CONTEXT: Outcomes of total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) as a function of age are not well known.

OBJECTIVE: To understand the effects of age on revision rate, mortality, and hospital readmissions.

DESIGN: A retrospective cohort study of prospectively collected data. Using an integrated health care system's shoulder arthroplasty registry, we identified patients who underwent TSA and RTSA between January 2007 and June 2012. Patients were grouped into older (> 75 years) and younger groups (≤ 75 years).

MAIN OUTCOME MEASURES: Differences in outcomes between both age groups.

RESULTS: The TSA cohort had 2007 patients, and 538 (26.8%) were older than age 75 years. Older patients who underwent TSA had higher risks of 1-year mortality (2.0% vs 0.6%; odds ratio = 3.34, 95% confidence interval [CI] = 1.00-11.11, p = 0.049) and readmission within 90 days (7.6% vs 4.4%; odds ratio = 1.75, 95% CI = 1.17-2.63, p = 0.007). The RTSA cohort had 568 patients, and 295 (51.9%) of them were older than age 75 years. Older RTSA patients had a lower risk of revision (3.7% vs 8.1%; hazard ratio = 0.45, 95% CI = 0.24-0.89, p = 0.020).

CONCLUSION: Patient age is one of many important variables that surgeons should consider when performing shoulder arthroplasty. However, the impact of age in the TSA and RTSA populations is different. In the TSA cohort, older patients have higher risk of readmission and mortality. In the RTSA cohort, older patients have lower risk of revision.