Shoulder arthroplasty in patients aged fifty-five years or younger with osteoarthritis

Background

The younger patient with glenohumeral arthritis presents a challenge because of concerns about activity and frequency of failure. The purpose of this study was to define the results, complications, and frequency of revision surgery in this group.

Materials and methods

Between 1986 and 2005, 46 total shoulder arthroplasties and 20 hemiarthroplasties were performed in 63 patients who were aged 55 years or younger and had chronic shoulder pain due to glenohumeral osteoarthritis. All 63 patients had complete preoperative evaluation, operative records, and minimum 2-year follow-up (mean, 7.0 years) or follow-up until revision.

Results

Nine shoulders underwent a revision operation. The implant survival rate was 92% (95% confidence interval, 77%-100%) at 10 years for total shoulder arthroplasty and 72% (95% confidence interval, 54%-97%) for hemiarthroplasty (Kaplan-Meier result). Patients who underwent total shoulder arthroplasty had less pain (P = .01), greater active elevation (P = .05), and higher satisfaction (P = .05) at final follow-up compared with those who underwent hemiarthroplasty. Complete radiographs were available for 47 arthroplasties with a minimum 2-year follow-up or follow-up until revision (mean, 6.6 years). More than minor glenoid periprosthetic lucency or a shift in component position was present in 10 of 34 total shoulder arthroplasties. Moderate to severe glenoid erosion was present in 6 of 13 hemiarthroplasties.

Conclusions

This study indicates that there is intermediate- to long-term pain relief and improvement in motion with shoulder arthroplasty in young patients with osteoarthritis. These results favor total shoulder arthroplasty in terms of pain relief, motion, and implant survival.

Level of evidence: Level IV, Case Series, Treatment Study

Keywords: Total shoulder arthroplasty, osteoarthritis, glenohumeral arthritis, young patient