Preoperative factors associated with loss of range of motion after reverse shoulder arthroplasty.

Abstract Background Reverse shoulder arthroplasty (RTSA) is a successful procedure, often allowing patients to achieve better range of motion (ROM) compared to their preoperative baseline. However, there is a subset of patients who either fail to improve or lose ROM postoperatively. These patients are at increased risk of poor satisfaction and patient reported outcomes (PROMs). To date, characteristics of this subset of patients have not been well described. The purpose of this study is to determine risk factors associated with loss of ROM after primary RTSA. Methods A retrospective review using a commercial international RTSA database (Exactech Inc, Gainesville, FL, USA) of patients undergoing primary RTSA between 2007 and 2017 was performed. 123 (7.7%) shoulders lost ≥ 10˚ of forward elevation (FE) (group 1, p1) and 183 (11.4%) lost ≥ 10˚ of external rotation (ER) (group 2, p2). Univariate and multivariate analyses were performed comparing these patients to control cohorts to evaluate risk factors for loss of motion. Results Better preoperative abduction, forward elevation, external rotation, and internal rotation were each associated with greater loss of FE (p1 Conclusion Patients with greater preoperative shoulder ROM or higher PROMs are at higher risk of losing ROM after primary RTSA. They are also at higher risk of reporting lower postoperative satisfaction, though the majority were still satisfied. Surgeons should strongly counsel patients with well-preserved preoperative function on the risk of loss of range of motion.