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Michel P. J. van den Bekerom1, Pieter C Geervliet2, Matthijs P Somford3, Maaike P. J. van den Borne3, Ronald Boer3
1 Department of Orthopaedic Surgery, OLVG, Amsterdam, Netherlands
2 Department of Orthopaedic Surgery, Gemini Hospital, Den Helder, Netherlands
3 Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands
Correspondence Address:
Michel P. J. van den Bekerom
Department of Orthopaedic Surgery, OLVG, P.O. Box 95500, Oosterpark 9, 1090 HM Amsterdam
Netherlands
 Source of Support: None, Conflict of Interest: None  | 7 |
DOI: 10.4103/0973-6042.118915
Introduction: The optimal surgical treatment of end-stage primary glenohumeral osteoarthritis remains controversial. The objective of this article is to systematically review the current available literature to formulate evidence-based guidelines for treatment of this pathology with an arthroplasty.
Materials and Methods: A systematic literature search was performed to identify all articles from 1990 onward that presented data concerning treatment of glenohumeral arthritis with total shoulder arthroplasty (TSA) or head arthroplasty (HA) with a minimal follow-up of 7 years. The most relevant electronic databases were searched.
Results: After applying the inclusion and exclusion criteria, we identified 18 studies (of the initial 832 hits). The search included a total of 1,958 patients (HA: 316 and TSA: 1,642) with 2,111 shoulders (HA: 328 + TSA: 1,783). The revision rate for any reason in the HA group (13%) was higher than in the TSA group (7%) (P < 0.001). There was a trend of a higher complication rate (of any kind) in the TSA group (12%) when compared with the HA group (8%) (P = 0.065). The weighted mean improvement in anteflexion, exorotation and abduction were respectively 33°, 15° and 31° in the HA group and were respectively 56°, 21° and 48° in the TSA group. Mean decrease in pain scores was 4.2 in the HA and 5.5 in the TSA group.
Conclusion: Finally, we conclude that TSA results in less need for revision surgery, but has a trend to result in more complications. The conclusions of this review should be interpreted with caution as only Level IV studies could be included.
Level of Evidence: IV.
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