Elective shoulder arthroplasty in patients older than ninety years of age

This study examined the outcome of elective shoulder arthroplasty for glenohumeral osteoarthritis or rotator cuff arthropathy in patients aged older than 90 years. The study included 7 shoulders in 6 patients with an average age of 93 years 5 months, (range, 91 years 0 months to 97 years 4 months). Average follow-up was 2.2 years, (range, 1-4 years). Preoperative range of motion, Simple Shoulder Test (SST) scores, and Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) scores were obtained and compared with postoperative values at 3 and 6 months and yearly thereafter. Average forward elevation improved from 87 degrees to 137 degrees (P < .00001), and external rotation to the side improved from 0 degrees to 50 degrees (P < .0001). The SST scores improved from a preoperative average of 2.0 to 6.1 at 3 months (P < .0001), 6.9 at 6 months (P < .0001), 8.0 at 1 year (P < .00001), and 7.4 at 2 years (P < .0001). Significant improvements occurred in 6 of 8 SF-36 domains: Mental Health (P < .05), Vitality (P < .01), Role limitations due to emotional problems (P < .05), Social Function (P < .001), Role limitations due to physical health (P < .001), and Comfort (P < .00001). No patient had worse pain or function postoperatively. These data suggest that elective shoulder arthroplasty can be performed in patients 90 years of age and older, providing excellent pain relief, improved functional outcome, and enhanced general health status.