I regularly review newly published, high-quality medical research and share patient-focused summaries explaining what the evidence means in everyday practice. These updates are intended to support informed discussions and shared decision-making, while recognising that treatment should always be tailored to the individual.
At the heart of my practice is Shared Decision-Making. Whether we pursue conservative management (Plan A) or surgical intervention (Plan B), the goal is to create a tailored treatment plan that aligns with your lifestyle, values, and functional goals.
Prepared by:
Prof. Bijay Singh
Consultant Orthopaedic Surgeon – Upper Limb, Trauma & Sports Injury
Shoulder | Elbow | Wrist | Hand
Visiting Professor Canterbury Christchurch University & AIIMS Raipur
NHS Appointments:
Spire Alexandra Hospital: 01634 – 687166
Medway NHS Trust: 01634 – 976749
Spire Alexandra Hospital
Medway NHS Trust
Why is this important?
Many patients over the age of 80 worry that they may be too old for shoulder replacement surgery. However, recent research shows that carefully selected elderly patients can achieve excellent pain relief and improved function.
What did the study look at?
- Systematic review of patients aged 80 years and older
- 15 studies included
- Over 2,800 shoulder replacements analysed
- Included both anatomic and reverse shoulder replacements
- Measured pain, movement, complications, and mortality
Key findings
- Near – Zero pain after surgery, ranging from 0 – 1.8 on a 10-point scale
- Excellent shoulder movements (150o for anatomic and 140 o for reverse replacements)
- 90‑day mortality ranged from 0% to 3%
- Reoperation rates were low
- Results were durable and often exceeded patient life expectancy
Complications reported
- After anatomic replacement: glenoid loosening (0–18%), rotator cuff tear (5.6–10%)
- After reverse replacement: scapular notching (0–40%), scapular fracture (4–9.4%)
- Reoperation rates: 0–6% for anatomic, 0–13% for reverse replacements
Professor Singh’s commentary
In Prof. Singh’s practice, the decision to operate is based on how you live, not when you were born. If you are healthy enough for the procedure and your shoulder pain is stealing your quality of life, age is not a contraindication. The “longevity” of these modern implants often exceeds the patient’s own longevity, meaning this is likely the last shoulder surgery you would ever need.
The Bottom Line: If you are 80+ and non-surgical treatments are no longer working, the science supports shoulder replacement as a safe, effective path back to an active life.
Prof. Singh has a detailed and honest discussion with every patient before surgery, including expected benefits, risks, and rehabilitation.
Key message
Shoulder replacement can be a safe and effective option for patients over 80. Age alone should not prevent someone from considering surgery if symptoms are severe. Treatment decisions should always be made through a shared decision‑making process.
Reference
DeBernardis J et al. Total shoulder arthroplasty in patients aged 80 years and older: a systematic review. Journal of Shoulder and Elbow Surgery, 2024.
