{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:55:25Z","timestamp":1790855725392,"version":"4.1.0"},"reference-count":35,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["eor.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:p>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Shoulder arthroplasty is increasingly utilised among patients under 55 years of age due to rising incidences of traumatic injuries, inflammatory arthritis, avascular necrosis, degenerative joint diseases and heightened participation in demanding sports and occupational activities.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Anatomic shoulder arthroplasty (ASA) remains the preferred surgical option for younger patients with intact rotator cuffs and minimal glenoid deformities, preserving natural biomechanics, strength and range of motion, and demonstrating high long-term implant survival rates at 10\u201315 years. Despite favourable outcomes, ASA carries potential long-term risks including implant wear, prosthetic loosening, glenoid erosion and progressive rotator cuff degeneration, particularly relevant for physically active younger patients.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Reverse shoulder arthroplasty (RSA) offers a valuable alternative in complex clinical scenarios characterised by irreparable rotator cuff tears, extensive glenoid bone loss, severe anatomical disruption or previous surgical failures. RSA can be used as an alternative to ASR for primary osteoarthritis and an intact rotator cuff, with excellent clinical outcomes and survivorship in patients over 60. RSA is also being used successfully in patients under the age of 55 with excellent short-term results.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>There remain concerns regarding the longevity and reliability of RSA in younger, highly active individuals. ASA can be revised to RSA with good clinical outcomes, while failure of RSA is extremely challenging to address.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>If we accept that ASA will fail with time, then the primary ASA should allow for ease of revision to an RSA. Recent advances in modular prosthetic designs facilitate simpler revisions from ASA to RSA.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>","DOI":"10.1530\/eor-2025-0052","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T07:53:35Z","timestamp":1748937215000},"page":"396-402","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":5,"title":["Shoulder replacement in the under 55\u2019s is anatomical or reverse the best solution?"],"prefix":"10.1530","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6530-069X","authenticated-orcid":true,"given":"Partha","family":"Sarangi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Clin Orthop Relat Res","first-page":"1860","article-title":"Future patient demand for shoulder arthroplasty by young patients: national projections","volume":"473","author":"Pedegimas EM","year":"2015","unstructured":"Pedegimas EM\n, \nMaltenfort M\n, \nLazarus MD\n, et al.\n Future patient demand for shoulder arthroplasty by young patients: national projections. 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Outcomes of reverse total shoulder arthroplasty in patients 60 years of age or younger: a systematic review. J Hand Surg 2020 45 254.e1\u2013254.e8. (https:\/\/doi.org\/10.1016\/j.jhsa.2019.06.009)"},{"key":"bib18","series-title":"J Shoulder Elbow Surg","first-page":"1032","article-title":"Stemless anatomic and reverse shoulder arthroplasty in patients under 55 years of age with primary glenohumeral arthritis: an analysis of the Australian Orthopaedic Association National Joint Replacement Registry at 5 years","volume":"34","author":"Jomaa M","year":"2025","unstructured":"Jomaa M\n, \nIngoe H\n, \nHollman F\n, et al.\n Stemless anatomic and reverse shoulder arthroplasty in patients under 55 years of age with primary glenohumeral arthritis: an analysis of the Australian Orthopaedic Association National Joint Replacement Registry at 5 years. J Shoulder Elbow Surg 2025 34 1032\u20131042. 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