**7. Conclusion**

Throughout this literature review, several limitations were encountered that include the following: unspecified "normal" postoperative physical rehabilitation protocols, risk factors pertinent to specific complications, and lack of research investigating the long term outcomes for RTSA. Additional research is needed to examine the aforementioned limitations to enhance future outcomes following RTSA.

Scapular notching, dislocations, and infections lead the forefront of persistent complications for RTSA. As evidenced in this literature review, the vast majority of improvement plateaus around 6 to 24 months. Thus, patient optimization may be accomplished by implementing a short-term course of preoperative physical therapy focused on shoulder girdle strength. Further, numerous inconsistencies and contradictions were observed in the literature regarding the impact of BMI on RTSA outcomes. Research requires further confirmatory evidence before making any strong conclusions about limiting the use of RTSA in patients with increased BMI. On the other hand, tobacco use negatively impacts the outcomes following RTSA by nearly doubling the overall complication rate.
