Shoulder replacement in younger patients
A talk at the Asia Pacific Orthopaedic Association Conference in Cairns on shoulder replacement in patients under 55.
Why age matters
Shoulder replacements are mechanical implants, and they wear over time. A replacement may eventually need revision, and a younger patient has more years ahead in which that can happen, as well as higher demands to place on the joint. That is the central problem in offering the operation to someone under 55.
What the registry data shows
Australian registry data at 14 years reports that approximately 83% of stemmed anatomic replacements and approximately 93% of reverse replacements remain in place without revision, with stemless anatomic replacements also proving durable. Individual results vary.
On that basis, most current replacements would be expected to last a considerable time, and figures of around 20 years are often cited. That expectation extends beyond the 14 years for which data currently exists, so it is a projection rather than an established figure.
The honest limitation
The evidence specifically relating to younger patients is limited. Registry survivorship figures are dominated by older patients, who place different demands on a replacement. Reverse and stemless anatomic replacements appear to be performing comparatively well in the under-55 group, but that observation rests on a small dataset and should be treated as preliminary.
For a younger person considering a shoulder replacement, this uncertainty is part of the discussion rather than a footnote to it.
Related information
See our anatomic total shoulder replacement and reverse total shoulder replacement pages, and our post on understanding the risks of total shoulder replacement.