A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study

Background More elderly patients are becoming candidates for total shoulder arthroplasty with an increase in frequency of the procedure paralleling the rise in other total joint arthroplasties. Controversy still exists, however, regarding the perioperative morbidity of total joint arthroplasty in elderly patients, particularly those 80 years of age and older. Questions/purposes We asked whether perioperative complications and mortality, transfusion requirements, inpatient length of stay, and discharge disposition after total shoulder arthroplasty were similar in patients 80 years and older compared with those in younger patients. MethodsWe retrospectively compared the 90-day complications, mortality, and other perioperative variables after total shoulder arthroplasty in 40 patients (43 shoulders) aged 80 years and older (Group A; mean age, 82 years) with 46 patients (47 shoulders) younger than 70 years (Group B; mean age, 61 years). Results We found no differences in complication rates between Group A and B, including systemic (26% versus 11%) and local (5% versus 9%) complications or major (7% versus 2%) and minor (23% versus 17%) complications. There were no deaths in either group. Group A had an increased transfusion requirement (16% versus 2%) and a decreased number of direct to home discharges (67% versus 98%

Section: Introductionmentioning

confidence: 99%

Total Shoulder Arthroplasty in Older Patients: Increased Perioperative Morbidity?

Ricchetti

Abboud

Kuntz

et al. 2011

“…PROMs can also be used to study the effects of treatment. Investigators at our institution have studied how orthopaedic surgery interventions improve health status following rotator cuff repair [37,39], glenohumeral instability [40,41], shoulder arthroplasty [27,28], and various nonunion treatments [11,12]. We have found the improvements in health-related quality of life after orthopaedic treatment to be quite dramatic.…”

Section: Types Of Studiesmentioning

confidence: 99%

Stakeholders in Outcome Measures: Review From a Clinical Perspective

Brinker

O’Connor

2013

“…The choice between HSA and TSA has been a topic of debate, with proponents of HSA arguing that it is a less invasive, faster, cheaper, and technically less demanding procedure, with quality of life outcomes equivalent to those of TSA. Though there is evidence to support these claims [4,8,16], more recent randomized controlled trials, multicenter studies, and meta-analyses have concluded that TSA is superior to HSA for treatment of primary glenohumeral osteoarthritis in terms of pain relief, function, ROM, strength, and patient satisfaction [4,5,8,20,21,27]. Furthermore, based on studies from 2003 and 2005, the American Academy of Orthopaedic Surgeons (AAOS), in its clinical practice guidelines from 2009 [13], recommend using TSA over HSA because it achieves superior pain relief, better global health assessment scores, and lower revision rates.…”

Section: Introductionmentioning

confidence: 99%

High Incidence of Hemiarthroplasty for Shoulder Osteoarthritis Among Recently Graduated Orthopaedic Surgeons

Mann

Baumhauer

O’Keefe

et al. 2014

Background Primary glenohumeral osteoarthritis is a common indication for shoulder arthroplasty. Historically, both total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) have been used to treat primary glenohumeral osteoarthritis. The choice between procedures is a topic of debate, with HSA proponents arguing that it is less invasive, faster, less expensive, and technically less demanding, with quality of life outcomes equivalent to those of TSA. More recent evidence suggests TSA is superior in terms of pain relief, function, ROM, strength, and patient satisfaction. We therefore investigated the practice of recently graduated orthopaedic surgeons pertaining to the surgical treatment of this disease. Questions/purposes We hypothesized that (1) recently graduated, board eligible, orthopaedic surgeons with fellowship training in shoulder surgery are more likely to perform TSA than surgeons without this training; (2) younger patients are more likely to receive HSA than TSA; (3) patient sex affects the choice of surgery; (4) US geographic region affects practice patterns; and (5) complication rates for HSA and TSA are not different.