Total Versus Hemiarthroplasty for Glenohumeral Arthritis According to Preoperative Glenoid Erosion.

Abstract

Clinical studies on primary osteoarthritis have shown better results of total shoulder arthroplasty (TSA) compared to hemiarthroplasty (HA) regarding the function, revision rate and postoperative pain relief. However, a clear recommendation for implantation of TSA or HA, depending on the glenoid type of erosion, does not exist. The aim of the study was to compare the results of TSA and HA with respect to the preoperative glenoid type. In this study, 41 patients were examined retrospectively; among them, 25 patients were treated with stemmed anatomic TSA and 16 with stemmed anatomic HA. The degree of osteoarthritis was determined according to Samilson and the glenoid erosion was classified according to Walch. The clinical outcome of the patients was determined by using the Constant Score (CS) and the Simple Shoulder Test at final follow-up. Patients after TSA demonstrated a significantly improved internal rotation compared to HA patients. Patients with preoperative B1 glenoid showed better pain relief after TSA compared to HA. For patients with preoperative type A2 glenoid a significantly higher CS was found after TSA compared to HA. We were able to show good short-term results after TSA and HA. Our findings suggest a better internal rotation for TSA compared to HA, superior clinical outcome for patients with preoperative A2 glenoid and lower pain level for patients with a preoperative B1 glenoid. However, these results need to be confirmed by further studies.