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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2010 August;61(4):267-83
Update on shoulder arthroplasty
Rapuri V. R., Hattrup S. J.
Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA
Shoulder arthoplasty is indicated for a number of diagnostic conditions, including osteoarthritis, rheumatoid arthritis, traumatic arthritis, cuff tear arthropathy, osteonecrosis, acute fractures of the proximal humerus, and prior failed arthroplasty. Each of these etiologic groups has specific pathologic nuances that warrant consideration by the surgeon to optimize the patient’s ultimate outcome. Additionally, the surgeon must choose between total shoulder arthroplasty, humeral head replacement, and now reverse shoulder arthroplasty. Total shoulder replacement has become increasingly recognized as providing superior outcomes for the osteoarthritic shoulder. The role of reverse shoulder arthroplasty continues to grow for those shoulders with deficiency of the rotator cuff and soft tissues despite concerns over durability. This now includes a debate over the choice of humeral head replacement versus reverse shoulder replacement for complex fractures of the proximal humerus. A consideration of the current information available in the literature helps guide the shoulder surgeon.