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Assessing the Value to the Patient of New Technologies in Anatomic Total Shoulder Arthroplasty
Corey J Schiffman1, Pooja Prabhakar1, Jason E Hsu1
1Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington.
Background:
Publications regarding anatomic total shoulder arthroplasty (TSA) have consistently reported that they provide significant improvement for patients with glenohumeral arthritis. New TSA technologies that have been introduced with the goal of further improving these outcomes include preoperative computed tomography (CT) scans, 3-dimensional preoperative planning, patient-specific instrumentation, stemless and short-stemmed humeral components, as well as metal-backed, hybrid, and augmented glenoid components. The benefit of these new technologies in terms of patient-reported outcomes is unknown.
Methods:
We reviewed 114 articles presenting preoperative and postoperative values for commonly used patient-reported metrics. The results were analyzed to determine whether patient outcomes have improved over the 20 years during which new technologies became available.
Results:
The analysis did not identify evidence that the results of TSA were statistically or clinically improved over the 2 decades of study or that any of the individual technologies were associated with significant improvement in patient outcomes.
Conclusions:
Additional research is required to document the clinical value of these new technologies to patients with glenohumeral arthritis.
Level Of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
