Long-Term Outcomes Following Reverse Total Shoulder Arthroplasty: A Systematic Review with a Minimum Follow-Up of 10 Years

Background: Reverse total shoulder arthroplasty (rTSA) is a crucial intervention for restoring shoulder function and alleviating pain. The aim of this review was to evaluate long-term clinical and radiological outcomes of rTSA patients with a minimum follow-up of 10 years. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, Web of Science, Embase, and Cochrane databases until September 2024. Studies in English or German with a minimum 10-year follow-up were included. Risk of bias was assessed using the Methodological Index for Non-Randomized Studies criteria. The study was registered with PROSPERO (CRD42024558828). Conclusion: RTSA appears to provide substantial long-term improvements in shoulder function, clinical outcomes, and pain relief, albeit with significant complication and revision rates. However, caution is warranted when interpreting the data due to high lost-to-follow-up rates and limited data quality in the contemporary literature. Long-term registry data will be essential. Level of evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.