I have severe pain and limited motion in my left shoulder. My problems all come from arthritis. My doctor thinks I should have a partial shoulder replacement. If the arthritis gets worse I can always have a total replacement later. Does it really work that way?
Many doctors hold to this idea. A recent review of the studies on partial (hemiarthroplasty) versus total shoulder replacements might call that plan into question.
Some studies show that even with a hemiarthroplasty the surface of the shoulder socket continues to wear down and deteriorate. Then when it's time to convert to a total shoulder, there isn't enough good, solid bone for the implant.
On the other hand, starting with a total shoulder arthroplasty (TSA) leaves the patient with no place to go if problems occur. There isn't a good replacement for the replacement.
Overall the studies done comparing hemiarthroplasty to a TSA show the TSA gives patients better function over a longer period of time. More studies are needed to fully compare these two treatment options.
Dianne Bryant, MSc, PhD, et al. a Comparison of Pain, Strength, Range of Motion, and Functional Outcomes After Hemiarthroplasty and Total Shoulder Arthroplasty in Patients with Osteoarthritis of the Shoulder. In The Journal of Bone and Joint Surgery. September 2005. Vol. 87-A. No. 9. Pp. 1947-1956.
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