What are the different types of shoulder replacement surgeries that might be considered when someone in their 40s or 50s needs one?

When younger individuals in their 40s or 50s face shoulder arthritis, several shoulder replacement options exist. Total Shoulder Arthroplasty (TSA) replaces both the ball (humeral head) and socket (glenoid). Hemiarthroplasty (HA) replaces only the ball, sometimes with glenoid preparation like 'Ream and Run' or Biologic Glenoid Resurfacing. Humeral Head Resurfacing (HHR) preserves more bone by resurfacing only the humeral head.

What are the benefits and potential drawbacks of Total Shoulder Arthroplasty (TSA) for younger, active individuals?

Total Shoulder Arthroplasty (TSA) is effective for pain relief and restoring function by replacing both the ball and socket of the shoulder joint. However, in younger, more active individuals, there are concerns about the long-term durability of the glenoid component. This can lead to loosening and the need for future revision surgeries, which is a significant consideration when evaluating this option.

How does Hemiarthroplasty (HA) work, and what are the different techniques used to address the glenoid (socket) side of the shoulder?

Hemiarthroplasty (HA) involves replacing only the ball of the shoulder joint, with variations in how the socket (glenoid) is addressed. 'Ream and Run' involves reaming the glenoid to stimulate fibrocartilage growth. Biologic Glenoid Resurfacing uses a graft to create a more durable surface on the glenoid. While HA can avoid some risks associated with glenoid component failure in Total Shoulder Arthroplasty (TSA), it may lead to glenoid arthrosis over time.

What is Humeral Head Resurfacing (HHR), and what are the potential advantages of this approach compared to a full shoulder replacement?

Humeral Head Resurfacing (HHR) preserves more of the natural bone by resurfacing the humeral head without a full replacement. This avoids cutting the anatomic neck and placing a stem, potentially simplifying future revision surgeries. This bone-sparing approach may be advantageous for younger patients who may need additional procedures later in life. However, its suitability depends on the specific condition of the shoulder joint and the extent of arthritis.

What factors should be considered when deciding on the best shoulder replacement option to ensure it lasts as long as possible?

Choosing the right shoulder replacement involves considering your age, activity level, the severity and type of arthritis, and your expectations for recovery. A detailed discussion with your surgeon is crucial to evaluate the pros and cons of Total Shoulder Arthroplasty (TSA), Hemiarthroplasty (HA), and Humeral Head Resurfacing (HHR). The goal is to select a procedure that provides pain relief, restores function, and maximizes the longevity of the replacement, tailored to your unique needs.

Young person with shoulder replacement enjoying an active lifestyle

Shoulder Replacement in Your 40s? What to Expect & How to Make It Last

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Navigating shoulder replacement surgery as a younger patient: understanding the options, challenges, and how to maximize long-term success."

Dealing with shoulder arthritis in your younger years (defined as before the typical age for shoulder replacement) presents unique challenges. It's not just about finding a solution, but finding one that will last through an active lifestyle and high expectations. It starts with a detailed discussion with your surgeon, considering your age, activity level, and what you hope to achieve.

Unlike older adults where the "gold standard" treatment, total shoulder arthroplasty (TSA), is well-established, there's less consensus for younger patients. This is because younger individuals tend to place higher demands on their shoulders, increasing the risk of implant wear and the need for future revision surgeries.

This article explores the different shoulder replacement options available to younger patients, their potential benefits and drawbacks, and strategies for maximizing the longevity of your shoulder replacement. Our aim is to equip you with the knowledge to have informed conversations with your doctor and make the best decision for your unique situation.

Understanding Your Shoulder Replacement Options

Young person with shoulder replacement enjoying an active lifestyle

When it comes to shoulder replacement for younger patients, there are several surgical techniques, each with its pros and cons:

Here's a breakdown of common options:

Total Shoulder Arthroplasty (TSA): This involves replacing both the ball (humeral head) and socket (glenoid) of the shoulder joint. While effective for pain relief and restoring function, concerns remain about the glenoid component's long-term durability in younger, more active patients.
Hemiarthroplasty (HA): This replaces only the ball of the shoulder joint. HA can be performed in a few different ways:
- Without Glenoid Preparation ("Ream and Run"): This technique involves reaming the glenoid to create a smooth surface for the humeral head to articulate against. It aims to stimulate fibrocartilage growth on the glenoid.
- With Biologic Glenoid Resurfacing: This involves using a graft (from your own tissue or a donor) to resurface the glenoid. The goal is to provide a more durable surface than bone-on-bone articulation.
- Humeral Head Resurfacing (HHR): This preserves more of the natural bone by resurfacing the humeral head instead of a full replacement. It avoids cutting the anatomic neck and avoids stem placement, potentially simplifying future revisions.

Each of these options offers the potential for improved pain and function. However, there are limitations to each. For example, while TSA is effective, glenoid loosening remains a concern. HA, on the other hand, can lead to glenoid arthrosis (wear and tear of the glenoid socket) over time.

Making the Right Choice & Maximizing Longevity

Choosing the best shoulder replacement option requires a detailed discussion with your surgeon. There's no one-size-fits-all solution, and the decision should be based on your individual needs and goals. Consider factors such as your age, activity level, the type and severity of your arthritis, and your expectations for recovery.

While some studies suggest TSA might be a superior and cost-effective option for younger patients, others advocate for HA in certain situations. Newer techniques like pyrocarbon humeral head resurfacing are also emerging, but long-term data is still limited. The key is to weigh the potential benefits and risks of each procedure.

Ultimately, successful shoulder replacement in younger patients is a collaborative effort. By understanding your options, having open communication with your surgeon, and committing to a rehabilitation program, you can increase your chances of a lasting and functional outcome.