Raval P, Singh Harvinder
Trauma and Orthopaedic, University Hospitals of Leicester, Leicester, United Kingdom.
University Hospitals of Leicester, Leicester, United Kingdom.
J Clin Orthop Trauma. 2025 Mar 19;65:102976. doi: 10.1016/j.jcot.2025.102976. eCollection 2025 Jun.
Shoulder arthroplasty is increasingly being used for definitive treatment of various shoulder pathologies, especially in more elderly patients. Controversy surrounds the optimal choice in total shoulder arthroplasty for elderly patients. In this review we discuss the options available when considering TSA for an elderly patient.
Anatomical total shoulder arthroplasty (ATSA) relies upon an intact, functioning rotator cuff. Reverse total shoulder arthroplasty (RTSA) relies upon a functioning deltoid for optimal outcomes. The setting of partial cuff tears. Both options confer their own advantages and disadvantages.ATSA are a valuable treatment option for elderly patients with severe shoulder arthritis or degenerative conditions, offering significant pain relief and functional improvement. While it provides numerous advantages, including pain relief, preservation of bone stock, and natural joint mechanics, careful patient selection and consideration of potential drawbacks such as rotator cuff integrity and surgical complexity are crucial for optimising outcomes in this population.RTSA has become a valuable treatment solution for elderly patients with complex shoulder conditions, offering significant pain relief, improved functionality, and enhanced quality of life. While careful consideration of patient factors and potential complications is necessary, RTSA continues to demonstrate favourable outcomes and good survivorship in the elderly.
Debate continues optimal shoulder arthroplasty management for elderly patients. Technology continues to advance the surgical technique for shoulder arthroplasty and address some of the challenges encountered. Research continues to try and help answer many of the debated areas of shoulder arthroplasty, but current evidence continues to show an improving trend in survivorship and long-term outcomes for most shoulder arthroplasty procedures.
肩关节置换术越来越多地用于各种肩部疾病的最终治疗,尤其是在老年患者中。老年患者全肩关节置换术的最佳选择存在争议。在本综述中,我们讨论为老年患者考虑全肩关节置换术时可用的选择。
解剖型全肩关节置换术(ATSA)依赖于完整、功能正常的肩袖。反向全肩关节置换术(RTSA)依赖于功能正常的三角肌以获得最佳效果。部分肩袖撕裂的情况。两种选择都有其自身的优缺点。ATSA是患有严重肩部关节炎或退行性疾病的老年患者的一种有价值的治疗选择,可显著缓解疼痛并改善功能。虽然它具有许多优点,包括缓解疼痛、保留骨量和自然的关节力学,但仔细选择患者并考虑潜在的缺点,如肩袖完整性和手术复杂性,对于优化该人群的治疗效果至关重要。RTSA已成为患有复杂肩部疾病的老年患者的一种有价值的治疗方案,可显著缓解疼痛、改善功能并提高生活质量。虽然有必要仔细考虑患者因素和潜在并发症,但RTSA在老年患者中继续显示出良好的治疗效果和生存率。
关于老年患者最佳肩关节置换术管理的争论仍在继续。技术不断推动肩关节置换术的手术技术发展并解决一些遇到的挑战。研究继续试图帮助回答肩关节置换术许多有争议的领域,但目前的证据继续表明大多数肩关节置换术的生存率和长期效果呈改善趋势。