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. 2022 Nov 17:35:140-144.
doi: 10.1016/j.jor.2022.11.006. eCollection 2023 Jan.

Best practice in shoulder arthroplasty-a reflective personal review

Affiliations

Best practice in shoulder arthroplasty-a reflective personal review

Sachin Kumar et al. J Orthop. .

Abstract

Introduction: Shoulder arthroplasty is uncommon but increasing in number when compared to hip and knee arthroplasty. The average UK shoulder surgeon performs less than 10 a year and revision surgery is even more rare. The surgeon should be familiar with surgical approaches, implant designs and preferably be fellowship trained to produce good outcomes.

Methods: Narrative review was undertaken and senior author's personal practice was discussed.

Results: The need for a clear understanding of indications and contraindications for both anatomic shoulder arthroplasty and reverse total shoulder arthroplasty, good preoperative planning, protocol-based peri-operative management and good rehabilitation protocol in the post operative period cannot be overemphasized.

Conclusion: We are still learning best practice and prosthesis designs have changed over the past years with extensive choices especially in Reverse arthroplasty. Each of these designs has unique biomechanical properties and require a deep understanding of indications. Good surgical training and the use of multi-disciplinary team meetings for complex cases should improve the safety and quality of surgery for patients and ultimately long-term outcome of shoulder arthroplasty.

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Conflict of interest statement

Cormac P Kelly is an advisor to Enovis (formerly Mathys UK) and Robert Jones and Agnes Hunt Hospital receives financial support for their Shoulder Fellowship training programme. Sachin Kumar: None.

Figures

Fig. 1
Fig. 1
The author's (CPK) technique of subscapularis repair and reinforcement.
Fig. 2
Fig. 2
Humeral bone changes at routine follow up (see red arrows). initially thought to be stress shielding, subsequent aspiration confirmed chronic infection with C. Acnes.

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