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Updated: May 7, 2026

Reverse Total Shoulder Arthroplasty

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Published on: July 5, 2011

Do patients outlive their shoulder prosthesis?

Tarek Haj Shehadeh¹, Adam Elsayed¹, Gary Updegrove¹

¹Department of Orthopedics and Rehabilitation, Milton S. Hershey Medical Center, Hershey, PA, USA.

Journal of Orthopaedics

|January 15, 2026

Summary

Younger patients (<65) undergoing total shoulder arthroplasty (TSA) face a higher risk of revision surgery but a lower mortality risk. Older patients (≥65) have lower revision rates but increased mortality, suggesting age-specific implant longevity and patient counseling needs.

Keywords:

Age Death Revision surgery Risk Shoulder replacement

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Area of Science:

Orthopedic Surgery
Biostatistics
Geriatric Medicine

Background:

Total shoulder arthroplasty (TSA) is a common procedure with increasing demand.
Revision surgery rates are critical indicators of TSA success and implant longevity.
Understanding age-related outcomes is crucial for patient counseling and surgical decision-making.

Purpose of the Study:

To compare revision surgery and mortality rates following TSA in patients aged <65 versus ≥65.
To evaluate the impact of age on the long-term outcomes of total shoulder arthroplasty.
To inform patient counseling and surgical planning based on age-specific risk profiles.

Main Methods:

A retrospective analysis of the TriNetX database.
Inclusion of patients undergoing TSA, stratified into two age cohorts: <65 and ≥65.
10-year follow-up to compare cumulative incidence of death and revision surgery between cohorts.

Main Results:

The cohort aged ≥65 (106,777 patients) had a mortality incidence of 22.9% and revision incidence of 6.1%.
The cohort aged <65 (28,244 patients) had a mortality incidence of 7.0% and revision incidence of 9.4%.
Younger patients (<65) showed significantly higher odds of revision (3.5% vs 3.2%) but lower odds of mortality (1.9% vs 7.2%) compared to older patients (≥65).

Conclusions:

Patients younger than 65 undergoing TSA have a higher likelihood of revision surgery.
Older patients (≥65) are more prone to mortality but less likely to require revision within the 10-year follow-up.
Distinct age-based risk profiles necessitate individualized patient counseling and surgical planning for TSA.