Aim:

This study aims to describe the shoulder arthroplasty options for
young and active patients (<60 years old) with glenohumeral
osteoarthritis.

Methods:

A systematic review of the literature was conducted by searching
on Pubmed database. Studies that reported outcomes of patients with
glenohumeral arthritis, younger than 60 years, that underwent shoulder
arthroplasty [(Hemiarthroplasty (HA), Hemiarthroplasty with biological
resurfacing (HABR), Total shoulder arthroplasty (TSA), Reversed total
shoulder arthroplasty (RSA)] were included. Data include patient
characteristics, surgical technique, range of motion, pain relief,
outcome scores, functional improvement, complications, need for and time
to revision.

Results:

A total of 1591 shoulders met the inclusion criteria. Shoulder
arthroplasty provided improvements in terms of ROM on the 3 plains,
forward flexion (FF), abduction (Abd) and external rotation (ER), in
different proportions for each type of implant. Patients submitted to
RSA had lower preoperative FF (p = 0.011), and the highest improvement
(Δ) in Abd, but the worst in terms of ER (vsTSA, p = 0.05). HA had
better ER postoperative values (vsRSA p = 0.049). Pain scores improved
in all groups but no difference between them (p = 0.642). TSA and RSA
groups had the best CS Δ (p = 0.012). HA group had higher complication
rates (21.7%), RSA (19.4%, p = 0.034) and TSA (19.4%, p = 0.629) groups
the lowest, and HABR had the highest rate of revisions (34.5%).

Conclusions:

HA had the highest rate of complications and HABR unacceptable
rates of revision. These implants have been replaced by modern TSAs,
with RSA reserved for complex cases. Surgeons should be aware of the
common pitfalls of each option.

Fonte H, Amorim-Barbosa T, Diniz S, Barros L, Ramos J, Claro R. Shoulder Arthroplasty Options for Glenohumeral Osteoarthritis in Young and Active Patients (<60 Years Old): A Systematic Review. J Shoulder Elb Arthroplast. 2022 Mar 23;6:24715492221087014. doi: 10.1177/24715492221087014. PMID: 35669623; PMCID: PMC9163728.