Arthroplasty of the Shoulder

Shoulder arthroplasty is performed for a variety of clinical reasons. A detailed history and physical examination are essential to evaluate symptoms, chronology, physical findings, function, and patient needs prior to surgery. A detailed cervical spine examination is also essential. Common diagnostics include plain radiographs, CT scan to evaluate the bony architecture, and MRI to evaluate the soft tissues. The three primary types of arthroplasty are hemiarthroplasty, total shoulder arthroplasty, and reverse shoulder arthroplasty. Hemiarthroplasty involves replacement of the humeral head and is commonly used for fracture, avascular necrosis, and degenerative disease in young active patients. Total shoulder arthroplasty involves replacement of the humeral head and glenoid articular surfaces. It is used for glenohumeral degeneration in the presence of an intact functional rotator cuff. Reverse shoulder arthroplasty involves placing a ball on the glenoid socket and a socket on the humerus. Its primary indication is degeneration or fracture in the presence of a dysfunctional or unreconstructable rotator cuff.