Shoulder arthroplasty in the young patient

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rheumatology

Background:

• Younger patients (<50 years) undergoing shoulder arthroplasty present unique challenges due to higher functional demands and longer life expectancy.
• Assessing the long-term performance of shoulder implants in this demographic is crucial for guiding treatment decisions.

Purpose of the Study:

• To evaluate the functional outcomes and implant performance of shoulder arthroplasties in patients aged 50 or younger at the time of surgery.
• To compare the effectiveness of different prosthesis types (total vs. hemiarthroplasty) and their performance across various underlying disease processes.

Main Methods:

• A retrospective review of 22 shoulder arthroplasties in 19 patients (age ≤50 at surgery) was conducted.
• Patient data were collected via telephone interviews, written questionnaires, and radiographic examinations.
• Patients were stratified by disease etiology (rheumatoid arthritis, avascular necrosis, trauma, hemophilic arthropathy) and implant type.

Main Results:

• Hemiarthroplasty demonstrated the highest functional scores in patients with hemophilic arthropathy.
• Patients with rheumatoid arthritis showed better outcomes with total shoulder arthroplasty compared to hemiarthroplasty.
• No significant downward trend in shoulder function was observed with longer follow-up periods, indicating no accelerated deterioration.

Conclusions:

• Shoulder arthroplasty can provide durable functional outcomes in young patients, even with longer follow-up periods.
• Prosthesis selection should consider the underlying pathology, with total shoulder arthroplasty potentially offering advantages for rheumatoid arthritis.
• Hemiarthroplasty is a viable option, particularly for hemophilic arthropathy, in this patient cohort.