Saturday, March 5, 2016

Innovations in shoulder arthroplasty - advances or passing fancies?

It seems that every month comes with new innovations in shoulder arthroplasty, each of which brings with it new learning curves and costs. In most cases we do not have evidence supporting the benefit of these new technologies to the patients receiving them. 

We thought this might be a good time to review some of these innovations with the plan of reviewing them in a year to see if there were data on their clinical superiority over the simpler approaches in common use.

Lesser tuberosity osteotomy

Stemless reverse

 Stemless anatomic

Hybrid glenoid  

"Biological resurfacing"

Patient specific instrumentation

Platform prosthesis

Three dimensional models

Posteriorly augmented glenoid components
Partial resufacing

Full resurfacing

Short humeral stems

Variable neck shaft angle prostheses

Metal back glenoid components

Bone ingrowth humeral stems

Until evidence of clinical superiority becomes available we will continue to use the approaches that have become standard in our pracice:

Total shoulder athroplasty using an all polyethlene glenoid component with an impaction grafted stemmed humeral component.

Reverse total shoulder athroplasty using a securely screw fixed offset glenosphere with an impaction grafted stemmed humeral component.


Check out the new Shoulder Arthritis Book - click here.

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