Anatomic total shoulder arthroplasty in patients under 50 and over 80 years of age. Part 1

Anatomic total shoulder arthroplasty is a widely used definitive surgical solution for end-stage glenohumeral joint osteoarthritis and is associated with good clinical outcomes. Anatomic total shoulder arthroplasty has a role for patients under 50 years of age who have exhausted nonoperative management and for patients over 80 years of age with an intact rotator cuff. Patients younger than 50 place greater demands on their replaced shoulders, raising concerns about implant survivorship and in particular the failure of the glenoid component. There are limited data on the long-term survivorship of anatomic total shoulder arthroplasty in patients under the age of 50 years in the literature. Modern bone-preserving designs utilizing newer materials may contribute to improved outcomes and survivorship. Achieving comparable functional outcomes in patients over 80 years of age remains a challenge with concerns related to rotator cuff failure. However, in appropriately selected patients over the age of 80 years, an anatomic total shoulder arthroplasty provides better pain relief and function than a reverse total shoulder arthroplasty.