Shoulder arthroplasty: prosthetic options and indications

Abstract

Glenohumeral arthropathy and failed shoulder arthroplasty can lead to debilitating pain, reduced motion and strength, and limited function. Primary osteoarthritis, posttraumatic osteoarthritis, rheumatoid arthritis, cuff tear arthropathy, and osteonecrosis are common in this patient population. Shoulder arthroplasty may fail because of problems with the prosthesis, such as wear, loosening, and dislocation of the components, or because of bone and soft-tissue problems, such as glenoid arthrosis and rotator cuff tear. The disparate pathogenesis of these processes presents unique challenges to the treating surgeon and requires diagnosis-specific treatment options, whether involving hemiarthroplasty, total shoulder arthroplasty, or reverse total shoulder arthroplasty. Until recently, prosthesis options were limited to a stemmed humeral component with or without a polyethylene glenoid component. The array of prosthetic options currently available allows individualized treatment.