title: Total shoulder arthroplasty versus hemiarthroplasty in patients with shoulder osteoarthritis: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  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 Two of the trials were published clinical trials, and the other 2 clinical trials were presented as unpublished abstracts.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).
  
  
  CONCLUSIONS
  The available evidence suggests that TSA is more effective than HA for patients with shoulder arthritis.
authors.affiliation: Department of Orthopedics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Duan
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Xingxing
authors.initials: X
authors.lastname: Dong
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Yu
authors.initials: Y
authors.lastname: Gao
authors.forename: Fuguo
authors.initials: F
authors.lastname: Huang
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Zhou
authors.initials: Z
authors.lastname: Xiang
mesh_terms: D019643:Arthroplasty, Replacement / Q000379:methods*; D062785:Hemiarthroplasty / Q000379:methods*; D006801:Humans; D010003:Osteoarthritis / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012782:Shoulder / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome
keywords: Hemiarthroplasty; Meta-analysis; Osteoarthritis; Total shoulder arthroplasty