Hemiarthroplasty Osteoarthritis

Shoulder Anatomical HemiarthroplastyHemiarthroplasty OAShoulder Resurfacing




Fewer complications than TSR

Simpler procedure

Indicated in younger patient




Glenoid wear after hemiarthroplasty

- potential for medial migration & progressive glenoid wear

- revision to TSR almost always alleviates symptoms


Hemiarthroplasty V TSR for OA


Sandow et al J Should Elbow Surg 1999

- study randomized after inspection of glenoid

- less pain with TSR

- high revision rate in Hemiarthroplasty for glenoid wear over time

- had to cease study as TSR results significantly superior


Lo et al JBJS Am 2005

- metanalysis

- TSR superior pain relief / active ROM / patient satisfaction


Similar in AVN and fracture


Less clear for RA

- risk of glenoid component loosening


Hemiarthroplasty + Biological Resurfacing


Elhassen et al JBJS Am 2009

- 13 patients average age 34

- glenoid resurfacing with achilles allograft

- 10/13 required revision at average 14 months for pain

- all had glenoid wear with no evidence of allograft


Indications Hemiarthoplasty


1.  Normal glenoid

- AVN / trauma

- replace glenoid later if needed

- simple procedure for elderly


2.  Young patient


3.  Glenoid insufficient bone stock


Clinical Case


Patient with OA treated with Hemiarthroplasty


Shoulder Hemiarthroplasty for Osteoarthritis AP


The patient developed pain 2 years later

Infection was excluded with blood tests

CT and bone scan indicative of glenoid wear

US demonstrated intact rotator cuff


CT Shoulder Hemiarthroplasty for OsteoarthritisBone Scan Shoulder Hemiarthroplasty for Osteoarthritis


Revision to TSR

- cemented 3 peg glenoid inserted

- modular body removed to access glenoid

- shorter body used to decrease humeral head height

- intra-operative GT Fracture treated with trauma body and sutures


Hemiarthroplasty revised to TSR