Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 20:7:24715492231207482.
doi: 10.1177/24715492231207482. eCollection 2023.

Primary Total Shoulder Arthroplasty is Superior to Hemiarthroplasty for the Treatment of Glenohumeral Arthritis: Analysis of 5-year Outcomes in a Large Surgical Database

Jason Long  1 , Kunal Varshenya  2 , Kier Blevins  1 , Julia Ralph  1 , Anna Bryniarski  1 , Caroline Park  1 , Lucy Meyer  1 , Brian Lau  1
Affiliations

Primary Total Shoulder Arthroplasty is Superior to Hemiarthroplasty for the Treatment of Glenohumeral Arthritis: Analysis of 5-year Outcomes in a Large Surgical Database

Jason Long et al. J Shoulder Elb Arthroplast. .

Abstract

Background: Total shoulder arthroplasty (TSA) is the preferred treatment for glenohumeral arthritis refractory to nonoperative measures. However, some surgeons have argued for a role for hemiarthroplasty (HA) in the setting of a smooth glenoid that articulates appropriately with the humeral head. The purpose of this study is to evaluate long-term revision rates and short-term postoperative complications in patients undergoing either HA or TSA for glenohumeral arthritis.

Methods: A retrospective review of patients who underwent HA and TSA was conducted using a commercially available national database. Demographics, postoperative complications, risk factors, revision rates, and costs were analyzed using 2 sample t-tests, chi-squared tests, and multivariate logistic regressions.

Results: Patients were stratified by operation: (1) HA (n = 1615) or 2) TSA (n = 7845). Patients undergoing primary TSA had higher rates of prior ipsilateral rotator cuff repair and corticosteroid injections. At 2 years, patients who underwent HA, 3.0% of patients had revision surgery, compared to 1.6% of patients who underwent TSA (P = .002); at 5 years, 3.7% of the HA cohort (P < .0001) had revision surgery, compared to 1.9% of patients who underwent TSA.

Conclusions: Patients undergoing TSA or RTSA for glenohumeral arthritis had higher preoperative co-morbidities but had no difference in short-term complication rates with a lower risk of revision surgery at both 2-year and 5-year follow-up when compared to HA. Increasing age, female sex, hyperlipidemia, postoperative infection, shoulder instability, and thromboembolism all independently increased odds for revision shoulder arthroplasty for glenohumeral arthritis.

Level of evidence level: III.

Keywords: glenohumeral joint arthritis; hemiarthroplasty outcomes; reverse shoulder arthroplasty; rotator cuff injury; shoulder hemiarthroplasty; total shoulder arthroplasty.

PubMed Disclaimer

References

    1. Singh JA, Sperling J, Buchbinder R, McMaken K. Surgery for shoulder osteoarthritis. Cochrane Database Syst Rev. 2010(10):CD008089. - PubMed
    1. Kerr R, Resnick D, Pineda C, Haghighi P. Osteoarthritis of the glenohumeral joint: a radiologic-pathologic study. AJR Am J Roentgenol. 1985;144(5):967–72. - PubMed
    1. Khazzam M, Gee AO, Pearl M. Management of glenohumeral joint osteoarthritis. J Am Acad Orthop Surg. 2020;28(19):781–9. - PubMed
    1. Padegimas EM, Maltenfort M, Lazarus MD, Ramsey ML, Williams GR, Namdari S. Future patient demand for shoulder arthroplasty by younger patients: national projections. Clin Orthop Relat Res. 2015;473(6):1860–7. - PMC - PubMed
    1. Neer CS, 2nd. Articular replacement for the humeral head. 1917. Clin Orthop Relat Res. 1994(307):3–6; discussion 2. - PubMed

LinkOut - more resources