Indications and Preoperative Evaluation for Anatomic Shoulder Arthroplasty

Anatomic shoulder arthroplasty is a reliable treatment option that improves pain and functional outcomes in patients with shoulder pain, stiffness, and articular surface damage. Indications for shoulder arthroplasty include primary glenohumeral osteoarthritis, post-traumatic arthritis, rheumatoid arthritis, osteonecrosis, and post-capsulorrhaphy arthritis due to shoulder instability. Anatomic total shoulder arthroplasty (TSA) is contraindicated in those with irreparable rotator cuff tears, active infection, deltoid insufficiency, and insufficient glenoid bone stock to support a glenoid component. Hemiarthroplasty (HHR) may be considered for certain patients not eligible for anatomic TSA, including those with rotator cuff arthropathy with preserved active range of motion. A trial of medical management is always reasonable prior to proceeding with shoulder arthroplasty. Preoperative planning includes a thorough history and physical exam, radiographs, laboratory studies, and advanced imaging in some cases. Appropriate preoperative planning can help improve outcomes and reduce complications.