RESEARCH ARTICLE


Total Shoulder Arthroplasty



Joaquin Sanchez-Sotelo*
Department of Orthopedic Surgery, Gonda 14, Mayo Clinic, 200 First Street SW, Rochester MN 55905, USA


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© Joaquin Sanchez-Sotelo; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopedic Surgery, Gonda 14, Mayo Clinic, 200 First Street SW, Rochester MN 55905, USA; Tel: 507-538-1953; Fax: 507-266-2533; E-mail: sanchezsotelo.joaquin@mayo.edu


Abstract

Shoulder arthroplasty has been the subject of marked advances over the last few years. Modern implants provide a wide range of options, including resurfacing of the humeral head, anatomic hemiarthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty and trauma-specific implants for fractures and nonunions. Most humeral components achieve successful long-term fixation without bone cement. Cemented all-polyethylene glenoid components remain the standard for anatomic total shoulder arthroplasty. The results of shoulder arthroplasty vary depending on the underlying diagnosis, the condition of the soft-tissues, and the type of reconstruction. Total shoulder arthroplasty seems to provide the best outcome for patients with osteoarthritis and inflammatory arthropathy. The outcome of hemiarthroplasty for proximal humerus fractures is somewhat unpredictable, though it seems to have improved with the use of fracture-specific designs, more attention to tuberosity repair, and the selective use of reverse arthroplasty, as well as a shift in indications towards internal fixation. Reverse shoulder arthroplasty has become extremely popular for patients with cuff-tear arthropathy, and its indications have been expanded to the field of revision surgery. Overall, shoulder arthroplasty is a very successful procedure with predictable pain relief and substantial improvements in motion and function.

Keywords: Arthroplasty, shoulder, osteoarthritis, shoulder fractures, cuff-tear arthropathy, reverse arthroplasty.