Total Shoulder Arthroplasty is associated With Less Pain and Better Functional Outcomes, but Humeral Head Resurfacing may be Preferred in Younger, Higher Demand Patients: A Short-Term Outcomes Study in Patients with Glenohumeral Osteoarthritis

Document Type : RESEARCH PAPER

Authors

1 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA

2 Summit Health Orthopaedics, Florham Park, NJ, USA

3 Hospital for Special Surgery, New York, NY, USA

4 Rothman Orthopaedics, Orlando, FL, USA

Abstract

Objectives: This study aimed to compare short-term outcomes following Total Shoulder Arthroplasty 
(TSA) and Humeral Head Resurfacing (HHR) in patients with glenohumeral osteoarthritis (GHOA).
Methods: A retrospective analysis included patients who had undergone either TSA or HHR for GHOA at a single 
institution. Baseline demographics, complications, range of motion (active forward flexion, FF and active external 
rotation, ER), visual analog scores (VAS), and Subjective Shoulder Values (SSV) were collected.
Results: A total of 69 TSA and 56 HHR patients were analyzed. More HHR patients were laborers (44% versus 
21%, P=0.01). There were more smokers in the TSA group (25% versus 11%, P=0.04) and more cardiovascular 
disease in the HHR cohort (64% versus. 6%, p<0.0001). Postoperative FF was similar, but ER was greater in the 
HHR (47° ± 15°) vs. TSA group (40° ± 12°, P = 0.01). VAS was lower after TSA vs. HHR (median 0, IQR 1 versus 
median 3.7, IQR 6.9, p<0.0001), and SSV was higher after TSA (89% ± 13% vs. 75% ± 20% after HHR; p<0.0001). 
Post-operative impingement was more common after HHR (32% vs. 3% for TSA, p<0.0001). All other complications 
were equivalent.
Conclusion: While younger patients and heavy laborers had improved ER following HHR, their pain relief was 
greater after TSA. Decisions on surgical technique should be based on patient-specific demographic and anatomic 
factors.
 Level of evidence: III

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 12, Issue 6
June 2024
Pages 400-406

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History

  • Receive Date: 11 May 2023
  • Revise Date: 26 April 2024
  • Accept Date: 17 April 2024

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