I'm 79 and the surgeon didn't blink, but my family think I'm too old for a shoulder replacement. Am I?

I need to think this out loud because my head is spinning a bit after the appointment. I am 79, right shoulder is worn out and has been stealing my sleep for the best part of two years, and the surgeon looked at the scan and started talking about a reverse replacement as if it were the most ordinary thing in the world. He did not so much as pause at my age.

My daughter, who came with me, is now convinced I am mad to even consider a big operation at 79. Her line is that at my age you leave well alone, and she keeps saying I am too old to bounce back from surgery like that. And honestly a part of me agrees with her, because everything you hear is about how the elderly do badly with operations and anaesthetics.

But I also cannot lift a kettle or reach my own top shelf and I have not slept in my bed in months. So which is it. Am I genuinely too old for this, or is 79 not the deciding thing everyone in my family assumes it is? I do not want to be a fool who has surgery she should not, but I do not want to write off a fixable shoulder over a number either.

Margaret I will just tell you my own story and let it speak. I had a reverse at 68, which I know is younger than you, but I was in the ward with two people well into their 80s having the same operation and both walked out fine. The surgeons doing these do not seem to treat the 80s as some cliff edge the way families do.

The bit that changed my thinking was realising the question is not really your age in years, it is whether you are otherwise well enough for a couple of hours of anaesthetic. My neighbour is 60 and would be a worse bet for surgery than you sound, because of his heart. A fit 79 is not the same as a poorly 79.

I made the exact assumption your daughter is making, just pointed at myself. I kept saying I was too old at 71 and my wife finally asked me too old according to who, because the surgeon clearly did not think so. Turned out the thing that mattered was not my birthday at all, it was whether my cuff was intact, which decided I got an anatomic total rather than a reverse. The age was almost a footnote. I would not let the number make the decision for you before the surgeon has even had the chance to.

Margaret, let me answer the actual question directly, because it is one I have with families constantly. Age on its own is not what decides whether a shoulder replacement is sensible. Shoulder replacements, both anatomic total and reverse, are performed routinely into the late 70s and 80s, and a healthy person in their late 70s is very often a good candidate. The number on its own tells me almost nothing.

What genuinely drives the decision is a handful of specific things. First, your fitness for the anaesthetic: your heart and lung reserve, your blood pressure control, diabetes if you have it, and how you handle day-to-day activity, all of which the pre-operative assessment exists to weigh. Second, the state of the rotator cuff and the bone, which decides whether it is a total or a reverse, not your age. Third, your own goals, because the operation is done to relieve pain and give you back reach and sleep, and at 79 that is a thoroughly reasonable thing to want. A worn shoulder that is stopping you sleeping and lifting a kettle is a strong indication at any age.

Where age does earn genuine caution is when it travels with other things: significant heart or lung disease, frailty, poorly controlled diabetes, or an active infection anywhere, because those raise the anaesthetic and healing risk regardless of the shoulder. Those are the questions your assessment will actually probe, rather than the year on your birth certificate. To put numbers on it, primary shoulder replacements sit around 90 percent still in place at 10 years, so durability is not the worry it might be at 40. Our page on shoulder replacement at what age sets this out, and whether you are a candidate lists what the assessment looks at.

One honest boundary: I am describing how the decision is framed in general, and I cannot tell you whether your own heart, lungs and bone make this a good idea. Only the surgeon and anaesthetist examining you and reading your notes can weigh that. Take your daughter back with you and put these exact questions to them.

Coming back to say thank you, all of you, this untangled something for me. I went back with my daughter and we asked the fitness questions straight out, and the anaesthetist went through my heart and chest properly and was happy. So it is going ahead, a reverse, in a few weeks. My daughter has come round now she has heard it is my heart and lungs they care about and not simply the number 79. I will report back from the sling once I am there. Feeling a great deal less like a foolish old woman and a great deal more like someone getting a fixable shoulder fixed.