Total shoulder arthroplasty versus hemiarthroplasty in patients with shoulder osteoarthritis: A meta-analysis of randomized controlled trials

Abstract Objectives Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are treatment choices for end-stage shoulder osteoarthritis. The decision of whether to use TSA or HA is controversial. The objective of this study was to compare the effects of TSA and HA for shoulder osteoarthritis. Methods We conducted a search for clinical studies that had been published in any language in December 2012 or before. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and several other databases. Randomized and quasi-randomized controlled clinical studies that evaluated different methods were included. At least two review authors independently performed the study selection, data collection, and data extraction. The software Revman 5.1 was used for the statistical analysis. Results This study included 4 clinical trials. Two of the trials were published clinical trials, and the other 2 clinical trials were presented as unpublished abstracts. A total of 146 patients with 153 shoulders were included in the trials. Compared with HA, TSA presents with a higher UCLA shoulder scale (MD 3.10, 95% CI 1.13–5.08) and a higher ASES (MD 10.17, 95% CI 1.40–18.87). There was no significant difference between TSA and HA for revision (RR 0.35, 95% CI 0.10–1.19), WOOS (MD 9.10, 95% CI −2.72 to 20.92), and incidence of instability (RR 0.88, 95% CI 0.19–3.98). HA had a lower operation time (MD 39.00, 95% CI 17.05–60.95). Conclusion The available evidence suggests that TSA is more effective than HA for patients with shoulder arthritis.