This 2007 systematic review by Radnay et al. pools data from 23 studies (1,952 patients) to directly compare total shoulder replacement (TSR) versus humeral head replacement (HHR) for primary glenohumeral osteoarthritis across four domains: pain relief, range of motion, patient satisfaction, and revision surgery rate.
When counseling a patient with end-stage primary glenohumeral osteoarthritis and intact rotator cuff, this review supports choosing TSR over HHR: the short-term advantage of avoiding glenoid resurfacing is outweighed by inferior pain relief, lower satisfaction, and a higher downstream revision burden — particularly the 8.1% HHR-to-TSR conversion rate.
If implant choice is at issue, all-polyethylene glenoid components carry a substantially lower loosening rate (1.7%) than metal-backed designs (6.8%).
This 2007 systematic review by Radnay et al. pools data from 23 studies (1,952 patients) to directly compare total shoulder replacement (TSR) versus humeral head replacement (HHR) for primary glenohumeral osteoarthritis across four domains: pain relief, range of motion, patient satisfaction, and revision surgery rate.
When counseling a patient with end-stage primary glenohumeral osteoarthritis and intact rotator cuff, this review supports choosing TSR over HHR: the short-term advantage of avoiding glenoid resurfacing is outweighed by inferior pain relief, lower satisfaction, and a higher downstream revision burden — particularly the 8.1% HHR-to-TSR conversion rate.
If implant choice is at issue, all-polyethylene glenoid components carry a substantially lower loosening rate (1.7%) than metal-backed designs (6.8%).