Complication and reoperation rates are higher compared to shoulder arthroplasty for primary glenohumeral joint arthritis ; however , the difference is not statistically significant .
When reverse shoulder arthroplasties ( RSA ) were considered as a subgroup and compared to anatomic shoulder replacements ( total shoulders and hemiarthroplasties ) , they showed a lower revision rate
Chronic anterior glenohumeral joint instability is a common situation and can lead to progressive cartilage deterioration and ultimately instability arthopathy .
Progressive cartilage deterioration can occur despite conservative or surgical treatment and the sequelae of these conditions are often addressed with total shoulder arthroplasty .
Aims of the present study were to analyze the available literature to describe the technical aspects of this particular operation and to report outcomes and complication rates .
The hypothesis was that shoulder arthropalsty in the sequelae of instability had lower outcomes and higher complication rates than arthroplasties for primary arthritis .
Shoulder arthroplasty to address the sequelae of instability arthropathy and stabilization procedures can be a challenging procedure as a consequence of the distorted anatomy and severe glenohumeral joint pathology .
Shoulder Arthroplasty with or without Resurfacing of the Glenoid in Patients Who Have Osteoarthritis*
Background : The indications for resurfacing of the glenoid in patients who have osteoarthritis of the shoulder are not clearly defined ; some investigators routinely perform hemiarthroplasty whereas others perform total shoulder arthroplasty . Methods : Forty-seven patients ( fifty-one shoulders ) who were scheduled to have a shoulder arthroplasty for the treatment of degenerative osteoarthritis were r and omly assigned , according to a r and om-numbers table , to one of two groups : replacement of the humeral head with resurfacing of the glenoid with a polyethylene component with cement ( total shoulder arthroplasty [ twenty-seven shoulders ] ) or replacement of the humeral head without resurfacing of the glenoid ( hemiarthroplasty [ twenty-four shoulders ] ) . All patients received the same type of humeral component , and all operations were performed by or under the direct supervision of the same surgeon . The patients were followed for a mean of thirty-five months ( range , twenty-four to seventy-two months ) postoperatively . Evaluation was performed with use of the scoring systems of the University of California at Los Angeles and the American Shoulder and Elbow Surgeons . Results : No difference was observed between the preoperative scores for the two groups of patients . Postoperatively , the mean scores with use of the University of California at Los Angeles system and the American Shoulder and Elbow Surgeons system were 23.2 points ( range , 10 to 31 points ) and 65.2 points ( range , 15 to 94 points ) , respectively , after hemiarthroplasty and 27.4 points ( range , 9 to 34 points ) and 77.3 points ( range , 3 to 100 points ) , respectively , after total shoulder arthroplasty . With the numbers available for study , no significant difference was found between the two operative groups with respect to the postoperative score . ( Thirty-five subjects per group would be needed , assuming an effect size of 0.60 and a power of 0.80 . ) Total shoulder arthroplasty provided significantly greater pain relief ( p = 0.002 ) and internal rotation ( p = 0.003 ) than hemiarthroplasty did . Total shoulder arthroplasty also provided superior results in the specific areas of patient satisfaction , function , and strength , although none of these differences were found to be significant , with the numbers available . Total shoulder arthroplasty was associated with increased cost ( $ 1177 ) , operative time ( thirty-five minutes ) , and blood loss ( 150 milliliters ) per patient compared with hemiarthroplasty . To date , none of the total shoulder arthroplasties in the study group have been revised . Hemiarthroplasty yielded equivalent results for elevation and external rotation . Three of the twenty-five patients who had had a hemiarthroplasty needed a subsequent operation for resurfacing of the glenoid . The mean cost for the revision operations was $ 15,998 . Conclusions : Total shoulder arthroplasty provided superior pain relief compared with hemiarthroplasty in patients who had glenohumeral osteoarthritis , but it was associated with an increased cost of $ 1177 per patient
Complication and reoperation rates are higher compared to shoulder arthroplasty for primary glenohumeral joint arthritis ; however , the difference is not statistically significant .
When reverse shoulder arthroplasties ( RSA ) were considered as a subgroup and compared to anatomic shoulder replacements ( total shoulders and hemiarthroplasties ) , they showed a lower revision rate
Chronic anterior glenohumeral joint instability is a common situation and can lead to progressive cartilage deterioration and ultimately instability arthopathy .
Progressive cartilage deterioration can occur despite conservative or surgical treatment and the sequelae of these conditions are often addressed with total shoulder arthroplasty .
Aims of the present study were to analyze the available literature to describe the technical aspects of this particular operation and to report outcomes and complication rates .
The hypothesis was that shoulder arthropalsty in the sequelae of instability had lower outcomes and higher complication rates than arthroplasties for primary arthritis .
Shoulder arthroplasty to address the sequelae of instability arthropathy and stabilization procedures can be a challenging procedure as a consequence of the distorted anatomy and severe glenohumeral joint pathology .