Comparison of Patients Undergoing Primary Shoulder Arthroplasty Before and After the Age of Fifty

Saltzman, Matthew D.; Mercer, Deana M.; Warme, Winston J.; Bertelsen, Alexander L.; Matsen III, Frederick A.
January 2010
Journal of Bone & Joint Surgery, American Volume;Jan2010, Vol. 92-A Issue 1, p42
Academic Journal
Background: The reported outcomes of shoulder arthroplasty in patients under the age of fifty years are worse than those in patients over fifty. While there are several possible explanations for this finding, we explored the possibility that patients who had a primary shoulder arthroplasty when they were under fifty years of age differed from those who had the procedure when they were over fifty with respect to their pre-arthroplasty self-assessed comfort and function, sex distribution, and specific type of arthritis. Methods: The study group consisted of patients with glenohumeral arthritis who were treated with a primary shoulder arthroplasty by the same surgeon between 1990 and 2008. For each decade of age, the sex distribution, the pre-arthroplasty self-assessed shoulder comfort and function, and the prevalence of twelve different diagnoses were documented. We reviewed the series for three potential causes of worse outcomes in patients under fifty years of age as compared with those over fifty years of age: (1) a higher percentage of women, (2) a lower score for pre-arthroplasty self-assessed comfort and function, and (3) more complex pathological conditions. Results: Patients under the age of fifty years were not more likely than those over fifty to be female or to have a lower pre-arthroplasty self-assessed comfort and function score, but they did have more complex pathological conditions, such as capsulorrhaphy arthropathy, rheumatoid arthritis, and posttraumatic arthritis. Only 21% of the younger patients had primary degenerative joint disease, whereas 66% of the older patients had that diagnosis. This difference was significant (p < 0.000000001). Conclusions: Surgeons performing shoulder arthroplasty in individuals under the age of fifty should be prepared to encounter pathological conditions such as capsulorrhaphy arthropathy, rheumatoid arthritis, and posttraumatic arthritis rather than primary osteoarthritis, which is more common in individuals older than fifty. The pathoanatomy in these younger patients may complicate the surgery, the rehabilitation, and the outcome of the shoulder arthroplasty.


Related Articles

  • Unfavourable results in the repair of the cleft lip. Narayanan, Puthucode V.; Adenwalla, Hirji Sorab // Indian Journal of Plastic Surgery;May-Aug2013, Vol. 46 Issue 2, p171 

    Introduction: Unfavorable results in unilateral and bilateral cleft lip repair are often easy to spot but not always easy to prevent as to treat. We have tried to deal with the more common problems and explain possible causes and the best possible management options from our experience....

  • Knee Arthroplasty and Risk of Hip Fracture: A Population-Based, Case-Control Study. Lalmohamed, Arief; Opdam, Frans; Arden, Nigel; Prieto-Alhambra, Daniel; Staa, Tjeerd; Leufkens, Hubertus; Vries, Frank // Calcified Tissue International;Feb2012, Vol. 90 Issue 2, p144 

    The majority of knee arthroplasties (KAs) are performed in patients with osteoarthritis (OA). Although bone mass may be increased in these patients, subjects with knee OA may have an increased risk of hip fracture, possibly due to an increased severity of falls. However, in patients with KAs,...

  • Adversity: A great teacher. Sharma, Ramesh Kumar // Indian Journal of Plastic Surgery;May-Aug2013, Vol. 46 Issue 2, p167 

    An introduction is presented in which the editor discusses various reports within the issue on topics including plastic surgical complications, unfavorable outcomes, and liposuction.

  • Clinical and radiographic reports following cervical arthroplasty: a 24-month follow-up. Yan Yang; Lin Nie; Lei Cheng; Yong Hou // International Orthopaedics;Aug2009, Vol. 33 Issue 4, p1037 

    Abstract��We reviewed patients with cervical disc prosthesis replacement for single-level cervical disc disease to evaluate its clinical effect and maintenance of cervical spine motion. Fifteen patients underwent Bryan artificial cervical disc replacement and were followed-up for at...

  • One hundred and twelve infected arthroplasties treated with DAIR (debridement, antibiotics and implant retention): antibiotic duration and outcome. Byren, I.; Bejon, P.; Atkins, B. L.; Angus, B.; Masters, S.; McLardy-Smith, P.; Gundle, R.; Berendt, A. // Journal of Antimicrobial Chemotherapy (JAC);Jun2009, Vol. 63 Issue 6, p1264 

    Objectives We describe treatment failure rates by antibiotic duration for prosthetic joint infection (PJI) managed with debridement, antibiotics and implant retention (DAIR). Methods We retrospectively collected data from all the cases of PJI that were managed with DAIR over a 5 year period....

  • Risk adjustment of Florida mental health outcomes data: concepts, methods, and results. Dow, Michael G.; Boaz, Timothy L.; Thornton, David; Dow, M G; Boaz, T L; Thornton, D // Journal of Behavioral Health Services & Research;Aug2001, Vol. 28 Issue 3, p258 

    This article discusses outcome evaluation systems for mental health programs. It reviews and critically evaluates design and analysis methods for strengthening the validity of such uncontrolled comparisons. The article examines methods for statistically adjusting preexisting groups, now referred...

  • Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: prospective US military cohort study. LeardMann, Cynthia A.; Smith, Tyler C.; Smith, Besa; Wells, Timothy S.; Ryan, Margaret A.K. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;4/25/2009, Vol. 338 Issue 7701, p992 

    Objective To determine if baseline functional health status, as measured by SF-36 (veterans), predicts new onset symptoms or diagnosis of post-traumatic stress disorder among deployed US military personnel with combat exposure. Design Prospective cohort analysis. Setting Millennium Cohort. I...

  • Clinical Features and Treatment Outcomes of Moyamoya Disease in 125 Patients of Henan, China. Hong-Wei CUI; Yan-Ru LIU; Bo-Ai ZHANG // Journal of Neurological Sciences;2013, Vol. 30 Issue 1, p48 

    Objective: We aim to describe clinical features and treatment outcomes of patients with Moyamoya disease (MMD) at a single center in China. Methods: Clinical features of a total of 125 cases of MMD from Henan, a provincial capital in China, were retrospectively analyzed. Follow-up studies were...

  • Technology can make a difference in outcomes for most arthroplasty Luddites. Cobb, Justin P. // Orthopaedics Today Europe;2012, Vol. 15 Issue 4, p4 

    The author reflects on the benefits of technology on clinical outcomes of arthroplasty amid skepticism among surgeons and looks at the reasons why previous surgical technology failed.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics