At the Korean Shoulder & Elbow Society congress
Dr Kenneth Cutbush was a guest speaker at the 31st Annual Congress of the Korean Shoulder & Elbow Society in Seoul. The talk concerned reverse shoulder replacement in patients under 55.
The society and the congress
The Korean Shoulder & Elbow Society is the national subspecialty society for shoulder and elbow surgery in South Korea, and its annual congress brings its members together with invited speakers from other countries. Being asked to speak as a guest at a meeting of that kind generally means presenting a unit's own series and its approach to an audience that may do things differently, and then taking questions on it. Exchanges of this sort are one of the ways practice in different countries gets compared rather than developing in isolation.
What a reverse total shoulder replacement is
A reverse total shoulder replacement reverses the normal arrangement of the joint. In the natural shoulder the ball sits on the upper arm bone and the socket on the shoulder blade. In a reverse replacement a ball is fixed to the shoulder blade and a socket to the upper arm, so that the deltoid muscle can raise the arm even where the rotator cuff tendons no longer work. An anatomic total shoulder replacement keeps the normal arrangement and depends on an intact cuff, while a hemiarthroplasty replaces only the ball. Which of them suits a particular shoulder depends on the state of the tendons, the bone and the socket. Individual results vary.
The problem in younger patients
Early evidence from the Australian Orthopaedic Association National Joint Replacement Registry suggests that reverse total shoulder replacement and stemless anatomic total shoulder replacement may be better suited to younger patients than hemiarthroplasty or traditional anatomic replacement, possibly with lower revision rates. That evidence is early, the numbers in this age group are small, and it should be treated as preliminary rather than settled. Individual results vary.
The countervailing consideration is activity. Younger patients tend to place higher demands on a replacement, which can accelerate wear and may in turn lead to further revision surgery. That trade-off is the substance of the discussion with any patient under 55 considering the operation.
Related information
- Our reverse total shoulder replacement page
- Our anatomic total shoulder replacement page
- Our post on shoulder replacement in patients under 55