Reverse total shoulder arthroplasty in younger patients

The utility of reverse total shoulder arthroplasty (rTSA) in younger patients has been long debated. Initial rTSA designs were highly constrained and led to increased rates of failure in the literature. This garnered concerns regarding implant longevity and the need for complex revision surgery in young and active patients. Thus, rTSA was reserved for older patients with decreased upper-extremity demand. However, recent advancements in both rTSA design and techniques have demonstrated promise for rTSA in young and active patients. Various techniques, including glenoid lateralization, humeral lateralization, and tendon transfers, aim to restore shoulder function and range of motion. Furthermore, patient-specific characteristics and comorbidities may be more valuable predictors of long-term success following rTSA compared to age, which has been arbitrarily defined in the literature.