Shoulder
arthroplasty has been the subject of marked advances over the last few years. Modern implants provide a wide range of options, including resurfacing of the humeral head, anatomic
hemiarthroplasty, total shoulder
arthroplasty, reverse shoulder
arthroplasty and
trauma-specific implants for fractures and nonunions. Most humeral components achieve successful long-term fixation without
bone cement. Cemented all-
polyethylene glenoid components remain the standard for anatomic total shoulder
arthroplasty. The results of shoulder
arthroplasty vary depending on the underlying diagnosis, the condition of the soft-tissues, and the type of reconstruction. Total shoulder
arthroplasty seems to provide the best outcome for patients with
osteoarthritis and inflammatory
arthropathy. The outcome of
hemiarthroplasty for proximal
humerus fractures is somewhat unpredictable, though it seems to have improved with the use of fracture-specific designs, more attention to tuberosity repair, and the selective use of reverse
arthroplasty, as well as a shift in indications towards internal fixation. Reverse shoulder
arthroplasty has become extremely popular for patients with
cuff-tear arthropathy, and its indications have been expanded to the field of
revision surgery. Overall, shoulder
arthroplasty is a very successful procedure with predictable
pain relief and substantial improvements in motion and function.