In their Internet advertising, many clinics that do shoulder-replacement surgery feature pictures of young and active people. Those images don’t necessarily square with current research about the outcomes that younger patients can expect if they undergo shoulder-replacement surgery.

A total shoulder replacement is major surgery, and like hand or ankle joint-replacement surgeries, shoulder replacements can be problematic. The structures of a shoulder joint and a hip or knee joint have little in common. A hip is a deep socket joint, and most of its stability comes from the way the joint fits tightly together. A knee is a hinge joint that has 90 percent of its motion in one front-back direction. The shoulder joint, however, is shallow. It moves through more range than a hip joint, and it’s stabilized mostly through muscles. These muscles usually are quite weak and banged up in the average patient who is considering a shoulder replacement.

Research published in the July 2013 issue of the Journal of Shoulder and Elbow Surgery showed that for patients younger than 55, about four in 10 shoulder replacements failed and had to be redone by 10 years after the surgery. This means that many patients who have shoulder-replacement surgery in their early 50s will need more surgeries on the horizon to remove and re-install new shoulder joints.

“40% of Shoulder Replacements in Patients Younger than 55 Fail by 10 Years” first appeared as a post on the Regenexx blog.