Is stemless total shoulder arthroplasty indicated in elderly patients?

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Geriatric Orthopedics

Background:

• Stemmed anatomic total shoulder arthroplasty is standard for glenohumeral osteoarthritis.
• Outcomes of stemless, modular total shoulder arthroplasty in elderly patients remain understudied.

Purpose of the Study:

• To compare clinical and radiographic outcomes of stemless anatomic total shoulder arthroplasty in elderly (≥70 years) versus younger (<70 years) patients.
• To test the hypothesis that outcomes are equivalent between these age groups.

Main Methods:

• Retrospective review of a prospectively collected database of patients undergoing primary, modular, stemless anatomic total shoulder arthroplasty.
• Assessment of patient-determined outcomes (WOOS, ASES, SANE, Simple Shoulder Test, Shoulder Activity Level) preoperatively and at 1 and 2 years postoperatively.
• Measurement of range of motion preoperatively and at 1 year postoperatively; radiographic assessment for complications.

Main Results:

• No significant differences in clinical outcomes (WOOS, ASES, SANE scores) or range of motion between elderly and younger patients.
• Similar rates of achieving minimal clinically important difference or substantial clinical benefit in both groups at 2 years.
• No radiographic complications were observed in either age group; intraoperative conversion rates to stemmed prostheses were comparable.

Conclusions:

• Age ≥70 years is not a contraindication for stemless anatomic total shoulder arthroplasty.
• Equivalent improvements in patient-reported outcomes and range of motion were observed in elderly and younger patient cohorts.
• Stemless arthroplasty demonstrated a favorable safety profile with no radiographic complications in either group.