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Evidence summaries

Surgery for Shoulder Osteoarthritis

Total shoulder arthroplasty compared with hemiarthroplasty appears to offer an advantage in terms of shoulder function, with no other clinical benefits. Level of evidence: "B"

The level of evidence is downgraded by imprecise results.

Summary

A Cochrane review [Abstract] 1 included 7 studies with a total of 238 subjects. Two studies (88 patients) compared hemiarthroplasty to total shoulder arthroplasty; three compared keeled and pegged humeral components; and one each compared navigation surgery to conventional and all-polyethylene to metal-backed implant. Patients who underwent hemiarthroplasty had statistically significantly worse functional scores on American Shoulder and Elbow Surgeons Shoulder Scale (100 point scale; higher = better) at 24 to 34 month follow-up compared to those who underwent total shoulder arthroplasty (mean difference, -10.05; 95% CI, -18.97 to -1.13; 2 studies, 88 patients), but no statistically significant differences between hemiarthroplasty and TSA were noted for pain scores (mean difference, 7.8; 95% CI, -5.33 to 20.93; 1 study, 41 patients), quality of life on short-form 36 physical component summary (mean difference, 0.80; 95% CI, -6.63 to 8.23; 1 study, 41 patients) and adverse events (Risk ratio, 1.19; 95% CI, 0.37 to 3.81; 1 study, 41 patients), respectively. A non-statistically significant trend towards higher revision rate in hemiarthroplasty compared to total shoulder arthroplasty was noted (RR, 6.18; 95% CI 0.77 to 49.52; 2 studies, 88 patients).

Clinical comments

Note

Date of latest search: 2009-12-14

References

  • Singh JA, Sperling J, Buchbinder R et al. Surgery for shoulder osteoarthritis. Cochrane Database Syst Rev 2010;(10):CD008089. [PubMed]

Primary/Secondary Keywords