This summary of a Cochrane review presents what we know from research about the effect of surgery on osteoarthritis of the shoulder.
The review shows that in people with osteoarthritis, total shoulder arthroplasty;
- may improve your pain compared with hemiarthroplasty
- probably does improve your shoulder physical function compared with hemiarthroplasty
- will probably lead to slightly less side effects such as fractures during surgery and infection, compared with hemiarthroplasty
We often do not have precise information about side effects and complications. This is particularly true for rare but serious side effects.
What is osteoarthritis and what are hemiarthroplasty surgery and total shoulder arthroplasty?
Osteoarthritis (OA) is a disease of the joints, such as the shoulder. When the joint loses cartilage, the bone grows to try and repair the damage. Instead of making things better, however, the bone grows abnormally and makes things worse. Osteoarthritis (OA) of the shoulder causes pain, stiffness and weakness in the shoulder joints. This can affect how well the shoulder moves and how well a person can do routine things at home or at work.
There are many types of surgery for OA of the shoulder. This review found results for two types of surgery.2
Shoulder hemiarthroplasty is the surgical replacement of only one part of the joint (the humeral head) with an artificial one. Total shoulder arthroplasty is the surgical replacement of parts of the joint with artificial ones. The choice of surgery is usually based on the condition of your shoulder joint.
Best estimate of what happens to people with osteoarthritis two years after the surgery:
Pain:
- people who had total shoulder arthroplasty rated their pain to be 6 on a scale of 0 to 100.
- people who had hemiarthroplasty rated their pain to be 14 on a scale of 0 to 100.
- people who had total shoulder arthroplasty rated their pain to be 8 points better after the surgery. (Absolute difference: 8%). This may be a result of chance.
Physical Function:
- people who had hemiarthroplasty rated their ability to be 65 on a scale of 0 to 100.
- people who had total shoulder arthroplasty rated their ability to move their shoulder to be 77 on a scale of 0 to 100 after the surgery.
- people who had total shoulder arthroplasty rated their ability to move to be 12 points better after the surgery. (Absolute difference: 10%)
Side effects:
- 24 people out of 100 who had hemiarthroplasty had side effects, like an infection.
- 20 people out of 100 who had total shoulder arthroplasty had side effects like an infection.
- 4 more people out of 100 had side effects with hemiarthroplasty (Absolute difference: 4%). This may be a result of chance.