Hemiarthroplasty and total shoulder arthroplasty

Since the development of the Neer I prosthesis in early 1950s, modern shoulder arthroplasty has evolved constantly and become a powerful and reliable tool for reconstruction of shoulders afflicted by various conditions. Newer designs and materials have been developed based on laboratory studies to better reproduce the anatomy and biomechanics of individual shoulders. Clinical outcomes also have been evaluated in clinical studies to measure the efficacy of new surgical techniques and implants. Clinical studies have demonstrated that, in general, shoulder arthroplasty offers an excellent treatment modality where both the patient and surgeon can enjoy a remarkable improvement of shoulder function and pain. However, indications are not completely agreed upon among surgeons, and the surgical techniques are ever evolving. Identification of appropriate surgical candidates and selection of surgical techniques and implants best suited for each patient are the foundation for successful shoulder arthroplasty. To this end, the present article reviews the history and indications, surgical technique, postoperative rehabilitation, and results of hemiarthroplasty and total shoulder arthroplasty.