title: Surgical Treatment Options for Glenohumeral Arthritis in Young Patients: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to compare surgical treatment options for young patients with glenohumeral arthritis.
  
  
  METHODS
  A systematic review of the English-language literature was conducted by searching PubMed, EMBASE, and Scopus with the following term: "(shoulder OR glenohumeral) AND (arthritis OR osteoarthritis) AND (young OR younger)." Studies that reported clinical or radiological outcomes of nonbiologic surgical treatment of generalized glenohumeral arthritis in patients younger than 60 years of age were included. Data were extracted to include study and patient characteristics, surgical technique, outcome scores, pain relief, satisfaction, functional improvement, return to activity, health-related quality of life, complications, need for and time to revision, range of motion, and radiological outcomes. Study quality was assessed with the Modified Coleman Methodology Score.
  
  
  RESULTS
  Thirty-two studies containing a total of 1,229 shoulders met the inclusion criteria and were included in the review. Pain scores improved significantly more after total shoulder arthroplasty (TSA) than after hemiarthroplasty (HA) (P < .001). Patient satisfaction was similar after HA and TSA. Revision surgery was equally likely after HA, TSA, and arthroscopic debridement (AD). Complications were significantly less common after AD than after HA (P = .0049) and TSA (P < .001). AD and TSA afforded better recovery of active forward flexion and external rotation than did HA. At radiological follow-up, subluxation was similarly common after HA and TSA.
  
  
  CONCLUSIONS
  According to current Level IV data, TSA provides greater improvement of pain and range of motion than does HA in the surgical treatment of young patients with glenohumeral arthritis. AD is an efficacious and particularly safe alternative in the short term for young patients with concerns about arthroplasty.
  
  
  METHODS
  Level IV, systematic review of Level IV studies.
authors.affiliation: College of Physicians and Surgeons, Columbia University, New York, New York, U.S.A.. Electronic address: etsayegh@gmail.com.
authors.forename: Eli T
authors.initials: ET
authors.lastname: Sayegh
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Randy
authors.initials: R
authors.lastname: Mascarenhas
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Chalmers
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Nikhil N
authors.initials: NN
authors.lastname: Verma
mesh_terms: D019643:Arthroplasty, Replacement / Q000379:methods*; D006801:Humans; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000502:physiology / Q000601:surgery*