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Review
. 2023 Sep;15(1 Suppl):4-14.
doi: 10.1177/17585732221075037. Epub 2022 Feb 3.

Anatomical shoulder replacements in young patients: A systematic review and meta-analysis

A Davies  1 , T Lloyd  2 , S Sabharwal  3 , A D Liddle  3 , P Reilly  1
Affiliations
Review

Anatomical shoulder replacements in young patients: A systematic review and meta-analysis

A Davies et al. Shoulder Elbow. 2023 Sep.

Abstract

Introduction: Increasing numbers of young patients receive shoulder replacements. Greater information on outcomes is needed to inform implant choice. The aim of this study was to investigate the survivorship and clinical effectiveness of hemiarthroplasty and anatomical total shoulder arthroplasty (TSA) in patients younger than 65 years.

Method: A systematic review was performed of MEDLINE, EMBASE, CENTRAL, The Cochrane Database of Systematic Reviews and National Joint Registry reports. The primary outcomes were implant survival and change in perioperative shoulder scores.

Results: Meta-analysis of implant survivorship was performed of six studies reporting on 416 patients. Implant survival was 86.1% (72.1,100) at 10 years for hemiarthroplasty and 82.3% (64.6,100) for TSA. 20 year survival was 80.0% for hemiarthroplasty (72.5,87.4) and 75.0% (56.9,93.1) for TSA. Ten studies were included in the meta-analysis of shoulder scores, multiple instruments were used. The standardised mean difference between pre-operative and post-operative shoulder scores was 2.15 (1.95, 2.35) for TSA at 4.2-4.9 years, and 2.72 (1.98,3.47) for hemiarthroplasty at 3.8-6 years.

Conclusion: Over 80% of shoulder replacements last more than 10 years, and 75% last more than 20 years. Significant improvements in shoulder scores are shown at all time points.

Keywords: arthroplasty; patient reported outcome measures; replacement; shoulder; survival.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA study flow diagram.
Figure 2.
Figure 2.
Survivorship: hemiarthroplasty (HA) and total shoulder arthroplasty (TSA) in patients 55 years or less.
Figure 3.
Figure 3.
Survivorship of hemiarthroplasties at 5, 10 and 20 years.
Figure 4.
Figure 4.
Survivorship of total shoulder arthroplasty at 5, 10 and 20 years.
Figure 5.
Figure 5.
Standardised mean difference in shoulder scores at mid-term follow-up for hemiarthroplasty.
Figure 6.
Figure 6.
Standardised mean difference in shoulder scores at mid-term follow-up for TSA.
Figure 7.
Figure 7.
Standardised mean difference in shoulder scores at long-term follow-up for TSA.
See this image and copyright information in PMC

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