Should tuberosities be reattached in patients over 80 years old treated with reverse shoulder arthroplasty after proximal humeral fractures?

Introduction: Reverse Shoulder Arthroplasty has shown better tuberosity healing rate when compared to hemiarthroplasty, but little information is known on how ageing affects tuberosity healing rate. The aim of this study was to evaluate the clinical and radiological outcomes of reverse shoulder arthroplasty after proximal humeral fracture in patients over 80 years old. Methods: We performed a retrospective study including 75 consecutive patients treated with a RSA because of a PHF. Patients were divided in two groups according to their age. Constant Score was recorded at 2 years follow-up. Healing rate of greater tuberosity was assessed on plain X-rays exams. Results: No differences were noted in tuberosity healing between groups. Functional outcomes of patients over 80, measured according to the Constant Murley Score, were slightly better when tuberosity healed without reaching significance. Gender, laterality, glenosphere size and ASA score had no effect in tuberosity healing. Conclusion: Tuberosity healing in RSA for PHF is not impaired in patients over 80 years old. Functional results in patients over 80 with healed tuberosities are slightly better than in those without healing.