Status of total shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rheumatology

Background:

• Degenerative, rheumatoid, and traumatic diseases of the glenohumeral joint often necessitate pain relief.
• Previous treatments lacked complete understanding of mechanical requirements for joint prostheses.

Purpose of the Study:

• To evaluate the efficacy of constrained versus non-constrained (resurfacing) prostheses for glenohumeral joint diseases.
• To compare pain relief, motion, and mechanical complications between different prosthesis types.

Main Methods:

• Clinical trials involving implantation of three types of constrained prostheses in 23 patients.
• Clinical trials involving implantation of 25 non-constrained (resurfacing) prostheses for glenohumeral joint replacement.

Main Results:

• Constrained prostheses offered satisfactory pain relief but required reoperations and limited motion (<90 degrees).
• Resurfacing prostheses provided excellent pain relief, no mechanical issues, and achieved >90 degrees of motion.
• Stability via capsular-muscle cuff repair proved less problematic than anticipated.

Conclusions:

• Resurfacing prostheses are superior to constrained types for glenohumeral joint disease treatment.
• Emphasis should shift towards repairing glenohumeral stabilizing structures rather than solely replacing them.