Results of Shoulder Joint Replacement in Young AdultsJoint replacements may be for the young at heart, but they usually are done in the over-65 crowd. They aren't usually given to the young in age. Joint implants have a limited life span and wear out. Saving them for older adults who are less active and put lower physical demands on their joints is the standard.
The shoulder joint may be a bit different. It doesn't take the daily pounding and weight-bearing that a hip or knee gets. It's easier to shield the shoulder from the physical stress of daily activities. But how well do shoulder joint replacements hold up in younger adults?
Researchers at the University of Florida followed 22 patients who had a shoulder replacement. All were younger than 50 at the time of the surgery. Some had rheumatoid arthritis (RA); others had joint damage from trauma or loss of blood supply. A lack of blood to the shoulder is called avascular necrosis. Several had joint damage from hemophilia, a bleeding disorder.
The researchers used telephone interviews and written surveys along with X-rays to follow the results. Patients were tracked for an average of five years. Questions were used to measure difficulty with activities in extremes of motion. For example, patients were asked, "Can you reach into your back pocket?" or "Can you use your arm overhead?"
The best shoulder function was seen in patients with hemophilia who had a partial joint replacement (hemi-arthroplasty). The next highest group had hemi-arthroplasty for trauma or avascular necrosis. These two groups had similar results.
Patients with the lowest score for function were seen in patients with RA. But patients with RA who got a total joint replacement did better than those with RA who had a hemi-arthroplasty.
The authors of this study think shoulder joint replacement is a good treatment option in younger patients. Compared with joint fusion or removing part of the joint, getting a new joint is worth thinking about, even for the young.
Paul L. Burroughs, MD, et al. Shoulder Arthroplasty in the Young Patient. In The Journal of Arthroplasty. September 2003. Vol. 18. No. 6. Pp. 792-798.
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