Total shoulder arthroplasty

Shoulder arthroplasty in the modern era was first performed in 1951. Total shoulder arthroplasty (TSA), which includes replacement of the articulating surface of the glenoid, dates to 1973. The intervening 20 years have witnessed multiple prosthetic and surgical approaches. Because the shoulder lacks a true bony socket it relies heavily on the support and integrity of its soft tissue for stability through its extensive range of motion. TSA is a complex and technically demanding procedure. It is however, routinely successful in skilled surgical hands. This article reviews the history of TSA, highlights recent advances and projects future trends and advances. An interdisciplinary Critical Path for short-term recovery is presented. Concluding commentary addresses long-term recovery.