Total Shoulder Replacement

- Discussion:
    - see shoulder replacement discussion
    - the indications for total shoulder arthroplasty (versus hemiarthroplasty) are somewhat unclear, since there is no clear advantage with
                    regard to pain relief or component survivorship;
            - in the prospective randomized study by GM Gartsman MD et al (JBJS 2000), the authors compared hemiarthroplasty (24 shoulders)
                  to total shoulder arthroplasty (27 shoulders);
                  - mean followup was 35 years;
                  - they noted significantly better pain relief and better internal rotation with total shoulder replacement;
                  - there was a trend for better patient satisfaction, function, and strength in the total shoulder replacement group;
    - references:
            - A Comparison of Pain, Strength, Range of Motion, and Functional Outcomes After Hemiarthroplasty and Total Shoulder Arthroplasty in Patients with Osteoarthritis of the Shoulder.
            - Shoulder Arthroplasty with or without Resurfacing of the Glenoid in Patients Who Have Osteoarthritis


    - non concentric glenoid:
            - certainly a non-concentric glenoid (ie posterior glenoid erosion) is a clear indication for glenoid resurfacing, since a congruent joint is
                  necessary for optimal function;
            - references:
                  - Recentering the Humeral Head for Glenoid Deficiency in Total Shoulder Arthroplasty.

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- Radiographs:
    - axillary view

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- Surgical Technique:
    - surgical exposure
    - humeral preparation
    - glenoid component:
    - trial reduction:

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- references:

- Shoulder arthroplasty for rheumatoid arthritis.
- Total shoulder arthroplasty versus hemiarthroplasty. Indications for glenoid resurfacing.
- Survivorship of unconstrained total shoulder arthroplasty.
- Total shoulder arthroplasty
- Total shoulder arthroplasty.
- The Dana total shoulder arthroplasty
- Total shoulder arthroplasty with the Neer prosthesis.
- The technique of total shoulder arthroplasty.   Rockwood CA Jr. Instr Course Lect.   39:437-47, 1990.
- Influence of Preoperative Factors on Outcome of Shoulder Arthroplasty for Glenohumeral Osteoarthritis
- A comparison of hemiarthroplasty and TSA in the treatment of primary glenohumeral osteoarthritis: Results of a multicenter study.
- A prospective functional outcome study of shoulder arthroplasty for osteoarthritis with an intact rotator cuff.
- Conversion of painful hemiarthroplasty to total shoulder arthroplasty: Long-term results
- Quality-of-Life Outcome Following Hemiarthroplasty or Total Shoulder Arthroplasty in Patients with Osteoarthritis.

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