Review of Total Shoulder ReplacementsTotal shoulder replacement (TSR) has been around since the early 1950s. Improved implant design has made this a popular treatment for shoulder osteoarthritis. In this review article, doctors from Columbia University present the pros and cons of partial versus TSR. Types of implants and surgical techniques are also discussed.
Replacing just one side of the shoulder joint is called a hemiarthroplasty. Usually the humeral head at the top of the upper arm is the half replaced. The other (socket) side is called the glenoid component. Studies show that 80 percent of patients who just have the humeral head replaced have good-to-excellent pain relief. They also report improved motion and strength.
Hemiarthroplasty is advised for younger, more active patients. They usually have a better chance for a balanced joint. They can always convert to a TSR later. The downside of this approach is that the results of hemiarthroplasty are unpredictable. It seems that TSR gives better function. There are fewer complications or second operations needed with a TSR compared to the hemiarthroplasty.
What does the future hold for shoulder replacements? The authors report new ideas for TSR are focused on getting rid of shoulder instability. There are too many problems right now with the glenoid implant coming loose. The search is on to find a more durable, biologic method of fixation. Implant design will continue to improve and allow for better matching to each patientâs anatomy.
Julie Keller, MD, et al. Glenoid Replacement in Total Shoulder Arthroplasty. In Orthopedics. March 2006. Vol. 29. No. 3. Pp. 221-226.
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