Shoulder arthroplasty in the elderly

Shoulder arthroplasty is increasingly being used for definitive treatment of various shoulder pathologies, especially in more elderly patients. Controversy surrounds the optimal choice in total shoulder arthroplasty for elderly patients. In this review we discuss the options available when considering TSA for an elderly patient.

Anatomical total shoulder arthroplasty (ATSA) relies upon an intact, functioning rotator cuff. Reverse total shoulder arthroplasty (RTSA) relies upon a functioning deltoid for optimal outcomes. The setting of partial cuff tears. Both options confer their own advantages and disadvantages.ATSA are a valuable treatment option for elderly patients with severe shoulder arthritis or degenerative conditions, offering significant pain relief and functional improvement. While it provides numerous advantages, including pain relief, preservation of bone stock, and natural joint mechanics, careful patient selection and consideration of potential drawbacks such as rotator cuff integrity and surgical complexity are crucial for optimising outcomes in this population.RTSA has become a valuable treatment solution for elderly patients with complex shoulder conditions, offering significant pain relief, improved functionality, and enhanced quality of life. While careful consideration of patient factors and potential complications is necessary, RTSA continues to demonstrate favourable outcomes and good survivorship in the elderly.

Debate continues optimal shoulder arthroplasty management for elderly patients. Technology continues to advance the surgical technique for shoulder arthroplasty and address some of the challenges encountered. Research continues to try and help answer many of the debated areas of shoulder arthroplasty, but current evidence continues to show an improving trend in survivorship and long-term outcomes for most shoulder arthroplasty procedures.