This is a single-institution retrospective review of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged 50 or younger. It reports minimum 15-year clinical and radiographic outcomes plus 20-year implant survival. The question: how durable is shoulder arthroplasty in young patients, and what predicts an unsatisfactory result?
When a patient 50 or younger needs shoulder arthroplasty, this paper reframes the hemi-versus-TSA debate. The old teaching was to avoid glenoid resurfacing in young, high-demand patients over loosening fears. This 20-year data undercuts that: TSA and hemiarthroplasty survival were not significantly different overall, and TSA was actually better at 10 years.
The key mental model: hemiarthroplasty leaves the native glenoid in place, and about 1 in 5 will need revision, mostly for painful glenoid arthritis around 8-9 years out. Glenoid erosion appears in most hemiarthroplasty shoulders long-term, especially in women.
Counsel young patients that pain relief is reliable but roughly half end up rated unsatisfactory, usually from stiffness and soft-tissue limitation rather than implant failure. Set realistic motion expectations, and consider non-arthroplasty options carefully before committing.
This is a single-institution retrospective review of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged 50 or younger. It reports minimum 15-year clinical and radiographic outcomes plus 20-year implant survival. The question: how durable is shoulder arthroplasty in young patients, and what predicts an unsatisfactory result?
When a patient 50 or younger needs shoulder arthroplasty, this paper reframes the hemi-versus-TSA debate. The old teaching was to avoid glenoid resurfacing in young, high-demand patients over loosening fears. This 20-year data undercuts that: TSA and hemiarthroplasty survival were not significantly different overall, and TSA was actually better at 10 years.
The key mental model: hemiarthroplasty leaves the native glenoid in place, and about 1 in 5 will need revision, mostly for painful glenoid arthritis around 8-9 years out. Glenoid erosion appears in most hemiarthroplasty shoulders long-term, especially in women.
Counsel young patients that pain relief is reliable but roughly half end up rated unsatisfactory, usually from stiffness and soft-tissue limitation rather than implant failure. Set realistic motion expectations, and consider non-arthroplasty options carefully before committing.