- Design
- Retrospective cohort, single institution
- Population
- 791 consecutive anatomic total shoulder arthroplasties, 2003–2015
- Primary outcome
- Implant survival and clinically important ASES thresholds at 10 years
- Effect
- Survival 96.1% at 10 years; 69.5% reached acceptable symptom state
This retrospective cohort followed 791 consecutive anatomic total shoulder arthroplasties performed between 2003 and 2015 at one US institution.
Implant survival was 96.1% at 10 years and 93.7% at 15 years. Younger age and a Walch B (posteriorly eroded) glenoid were independently associated with revision. Patient-reported scores stayed improved but drifted down over time: at 10 years, 69.5% of shoulders reached the patient acceptable symptom state, 79.9% the minimal clinically important difference and 55.8% a substantial clinical benefit.
The practical point is in how outcomes are explained. Revision-free survival overstates durable success if a patient expects the shoulder to stay as good as it was at one year. Consent conversations should include both figures, with extra caution for younger patients and posterior glenoid erosion.
- Quote both implant survival and the share achieving meaningful benefit when consenting
- Warn patients that shoulder function often declines gradually over a decade
- Discuss higher revision risk in younger patients and Walch B glenoids
- Record baseline ASES scores so long-term change can be measured
Why it matters
It challenges the habit of equating no revision with a successful replacement.
Don't overread it
A single-institution retrospective series with one implant philosophy; results may differ elsewhere.
The statistics, in plain English
About 7 in 10 shoulders were 'acceptable' to the patient at 10 years, and about 1 in 2 reached a large benefit. These thresholds were anchored to patient satisfaction in this cohort, so they may not transfer exactly to other populations.
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