New research from Mercy Health Physician and orthopedic surgeon Samer Hasan, MD, PhD is helping determine the best treatment options for younger patients with shoulder arthritis.

“Shoulder arthritis in the young is challenging to treat,” says Dr. Hasan. “Many of these patients have suffered serious trauma to their shoulder joint or have developed joint collapse with chronic steroid use, or even chondrolysis, a severe type of arthritis that has been linked to the use of intra-articular pain pumps. Most are living with chronic shoulder pain and stiffness and they have high expectations about the relief that orthopedic surgery can provide.”

While many studies highlight the benefits of shoulder replacement in older patients, including pain relief and restored function, some surgeons have concerns about performing shoulder replacement surgery in younger patients given that:

  • Young patients often have the greatest demands on their shoulders for both work and sport
  • Their life expectancy is longer, often to the point that they may require more than one revision of their replacement in their lifetime

Since 2001, Dr. Hasan has performed over 1300 shoulder replacements, including nearly 40 shoulder replacements in patients 40 years old or younger. He recently conducted a study of the clinical and radiographic outcomes of shoulder replacement surgery in this young population - the first such study in a group of patients this young -  specifically to understand the surgery’s impact. Dr. Hasan determined the following:

  • Patients experienced improved shoulder range of motion, including arm elevation and rotation, following shoulder replacement surgery
  • Patients experienced a substantial decrease in shoulder pain

The results for patients undergoing shoulder replacement for chondrolysis were similar, although some patients experienced residual pain. Two patients with chondrolysis who underwent partial shoulder resurfacing required revision surgery for persistent pain.

“The current study demonstrates that shoulder replacement in very young patients provides substantial improvements in active range of motion, irrespective of diagnosis. It remains a reasonable option for young patients with symptomatic advanced shoulder arthritis, and those who have failed less invasive or arthroscopic treatment,” said Dr. Hasan. 

“However, the early failure rate in partial shoulder replacement and resurfacing patients is concerning. Young patients should consider shoulder replacement surgery only after understanding their risk for further surgery later on in life. We will need to conduct longer follow-up studies of these patients to determine what role, if any, partial shoulder resurfacing should play in the treatment of young patients with shoulder arthritis,” he adds.

Dr. Hasan presented this research as a podium presentation at the Annual Meeting of the American Academy of Orthopaedic Surgeons in New Orleans, Louisiana on March 6, 2018. He presented earlier versions of this work with shorter term follow-up at large international meetings in Paris in February 2017 (Paris International Shoulder Course) and in Shanghai in June 2017 (ISAKOS).

Dr. Hasan practices from Mercy Health - Cincinnati Sports Medicine and Orthopedic Center locations in Montgomery and in Crestview Hills. For more information or to schedule an appointment, please call 513-347-9999.

Mercy Health is the source for the most comprehensive sports medicine care in Cincinnati, with an easily accessible network of healthcare professionals providing the most modern care available for athletes of all levels; athletic trainer coverage for over 30 local high schools and colleges, multiple club sports and performing arts organizations, including the Cincinnati Bengals, Miami Red Hawks and the Cincinnati Ballet; outpatient rehabilitation with special attention to restoring function; injury prevention training; performance training and an ongoing commitment to education and research. Its high school partners benefit from the most robust school partnership in the region.