ICL 207 Glenhumeral Arthritis in the Young Patient: Arthroscopic and Other Options-Shoulder Arthroplasty Options in Young (<50 yr old) Patients

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Video Summary

This lecture reviews shoulder arthroplasty outcomes in patients younger than 50, emphasizing challenges due to their longer life expectancy and higher activity demands. Studies show good pain relief and motion improvement with both hemiarthroplasty and total shoulder arthroplasty (TSA), but glenoid erosion, especially after hemiarthroplasty, remains a major long-term issue, leading to revision surgeries typically after 5–8 years. TSA demonstrates better survivorship and clinical results than hemiarthroplasty, particularly when glenoid involvement exists. Younger patients have a higher revision risk than older ones. Alternatives like biological glenoid resurfacing and soft tissue interposition show promising but inconsistent short-term results with limited long-term data. Current recommendations suggest arthroscopic management initially, with arthroplasty choice based on glenoid condition and patient demands. Overall, no one-size-fits-all solution exists; surgeons must cautiously weigh options to delay or optimize arthroplasty outcomes in young patients, considering each case individually and exploring adjunctive biological procedures as potential options.

Keywords

shoulder arthroplasty

young patients

hemiarthroplasty

total shoulder arthroplasty

glenoid erosion