Short to mid-term functional outcomes of stemless anatomical total shoulder arthroplasty in patients over 70 years of age.

Abstract

Introduction: Anatomical total shoulder arthroplasty (ATSA) is the gold standard for treating primary glenohumeral osteoarthritis (GHOA) in patients with an intact rotator cuff. Recently, reverse total shoulder arthroplasty (RTSA) is increasingly used in patients over 70. Stemless ATSA designs aim to reduce stem-related complications and simplify revisions. This study evaluates functional outcomes and complication rates of stemless ATSA in patients aged 70+ with an intact rotator cuff and at least two years of follow-up.

Methods: Forty-three patients met the inclusion criteria. Outcomes were assessed using the Oxford shoulder score (OSS), subjective shoulder value (SSV), and numeric rating scale (NRS) for pain at rest and during activity. Postoperative complications were documented.

Results: Thirty-three patients completed follow-up (mean 49.2 months). OSS improved by a mean of 21.7 points (median 48, IQR 42.5-48). SSV increased by 49.5%, NRS pain decreased by 5.7 (rest) and 6.8 (activity), all statistically significant (P < 0.001). Complications included one revision for rotator cuff failure (3%) and one asymptomatic biceps tenodesis failure. No outcome differences were found between age groups 70-79 and 80+.

Conclusion: Stemless ATSA in patients aged 70+ with an intact rotator cuff yields significant functional improvement and low complication rates at short- to mid-term follow-up.