Total Shoulder Arthroplasty—Indications, Technique, and Results
More patients are becoming candidates for total shoulder arthroplasty (TSA), with an increase in frequency of the procedure paralleling the increase in other total joint arthroplasties. TSA is indicated in the treatment of advanced primary and secondary arthritic conditions of the shoulder after failure of nonoperative management. Studies have shown survivorship rates comparable with other joint arthroplasties at short-, mid-, and long-term follow-up, and substantial improvements in pain relief, patient satisfaction, and objective measures, such as range of motion, strength, and shoulder outcome scores. Complications can occur, however, and technical problems, such as component placement and fixation, are prominent features among unsatisfactory arthroplasties. Therefore, appropriate surgical technique is essential in minimizing complications and maximizing functional outcomes after shoulder arthroplasty. The purpose of this article is to review the indications, surgical technique, and results of TSA. Careful patient selection, preoperative planning, surgical technique, and postoperative management remain essential to a successful patient outcome after TSA.
Keywords: indications, results, surgical technique, total shoulder arthroplasty
Dr Williams has the following conflict of interests to disclose: royalties from a company or supplier (DePuy); speakers bureau/paid presentations for a company or supplier (DePuy, Mitek); paid consultant or employee for a company or supplier (Tornier); stock or stock options in a company or supplier (in vivo Therapeutics); research or institutional support from a company or supplier (Tornier); royalties, financial or material support from publishers (Journal of Shoulder and Elbow Surgery, Wolters Kluwer Health—Lippincott Williams and Wilkins); medical/orthopedic publications editorial/governing board (operative Techniques in orthopedics, Techniques in Shoulder and Elbow Surgery); board member/committee appointments for a society (American Shoulder and Elbow surgeons, Pennsylvania Orthopaedic Society).
PII: S1048-6666(10)00091-1
doi:10.1053/j.oto.2010.11.001
© 2011 Elsevier Inc. All rights reserved.
