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. 2013 Jul;7(3):110-5.
doi: 10.4103/0973-6042.118915.

Total shoulder arthroplasty versus hemiarthroplasty for glenohumeral arthritis: A systematic review of the literature at long-term follow-up

Michel P J van den Bekerom  1 , Pieter C Geervliet, Matthijs P Somford, Maaike P J van den Borne, Ronald Boer
Affiliations

Total shoulder arthroplasty versus hemiarthroplasty for glenohumeral arthritis: A systematic review of the literature at long-term follow-up

Michel P J van den Bekerom et al. Int J Shoulder Surg. 2013 Jul.

Abstract

Introduction: The optimal surgical treatment of end-stage primary glenohumeral osteoarthritis remains controversial. The objective of this article is to systematically review the current available literature to formulate evidence-based guidelines for treatment of this pathology with an arthroplasty.

Materials and methods: A systematic literature search was performed to identify all articles from 1990 onward that presented data concerning treatment of glenohumeral arthritis with total shoulder arthroplasty (TSA) or head arthroplasty (HA) with a minimal follow-up of 7 years. The most relevant electronic databases were searched.

Results: After applying the inclusion and exclusion criteria, we identified 18 studies (of the initial 832 hits). The search included a total of 1,958 patients (HA: 316 and TSA: 1,642) with 2,111 shoulders (HA: 328 + TSA: 1,783). The revision rate for any reason in the HA group (13%) was higher than in the TSA group (7%) (P < 0.001). There was a trend of a higher complication rate (of any kind) in the TSA group (12%) when compared with the HA group (8%) (P = 0.065). The weighted mean improvement in anteflexion, exorotation and abduction were respectively 33°, 15° and 31° in the HA group and were respectively 56°, 21° and 48° in the TSA group. Mean decrease in pain scores was 4.2 in the HA and 5.5 in the TSA group.

Conclusion: Finally, we conclude that TSA results in less need for revision surgery, but has a trend to result in more complications. The conclusions of this review should be interpreted with caution as only Level IV studies could be included.

Level of evidence: IV.

Keywords: Arthroplasty; complication; glenoid; humerus; osteoarthritis; revision rate; shoulder; systematic review.

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Conflict of interest statement

Conflict of Interest: There are no conflicts of interest.

Figures

Figure 1
Figure 1
PubMed/MedLine search strategy
Figure 2
Figure 2
Flowchart summarizing the selection procedure for the articles eligible for systematic reviewing
See this image and copyright information in PMC

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