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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2009 April;60(2):173-9
Conventional hemiarthroplasty. Are there still indications?
Sperling J. W., Duncan S. F. M., Antuna S. A.
1 Department of Orthopedic Surgery Mayo Clinic, Rochester, MN, USA
2 Department of Orthopedic Surgery Mayo Health System, Owatonna, MN, USA
3 Shoulder and Elbow Unit Hospital Universitario La Paz Universidad Autónoma de Madrid, Madrid, Spain
The decision between hemiarthroplasty and total shoulder arthroplasty remains a controversial choice for the patient with shoulder arthritis. Multiple factors need to be considered when making the final decision between these two procedures. The process begins with a thorough understanding of the patient’s symptoms, motivation, and ability to comply with postoperative rehabilitation and restrictions. In addition, a thorough history, physical examination and appropriate imaging studies play an important role in helping to guide clinical decision making. One may consider hemiarthroplasty in patients with severe glenoid wear that precludes placement of a glenoid component, rotator cuff arthropathy in the younger patient, as well as those patients who are unwilling to live with the restrictions of having a glenoid component. In the typical patient with an intact rotator cuff and adequate glenoid bone stock, the decision is based primarily on the patient’s activity level and understanding of the trade off of increased activity with a hemiarthroplasty in return for a lower chance at pain relief.