Hemiarthroplasty versus total shoulder prosthesis: results of cemented glenoid components

In this retrospective study, we compared the results of 705 total shoulder arthroplasties (TSAs) with 469 hemiarthroplasties (HSAs), all having been performed with the Aequalis shoulder prosthesis. Each group, both TSA and HSA, was comparable by age (mean, 63.9 years) and sex (853 men and 321 women). Each group had comparable dominance and preoperative Constant scores (mean, 29 points). The length of follow-up averaged 43 months (range, 24-110 months) in both groups. The postoperative functional outcome and subjective assessment demonstrated the superiority of TSA over HSA independent of age or rotator cuff status (Constant score, 65.7 vs 56.3 points). The analysis of the radiographs showed a disturbing 68% of cases with radiolucent lines developing around the glenoid component and their subsequent progression with time. We saw an adverse effect on functional outcome by the presence of these radiolucent lines. This review would suggest that TSA is superior to HSA in most cases with chronic pathologic entities. HSA remains a satisfactory solution in specific cases. In the future, we need to optimize the designs of the glenoid implant and develop a better implantation technique to avoid the problems associated with glenoid replacement.