Hemiarthroplasty or total shoulder replacement in glenohumeral osteoarthritis?

Shoulder arthroplasty has proven to be a successful option in the treatment of glenohumeral osteoarthritis. Although introduced in the 1970s by Ch. Neer, resurfacing of the glenoid remains controversial. With regard to some single prospective studies total shoulder replacement (TSR) seems to be superior to humeral head replacement (HHR) in the treatment of concentric osteoarthritis. The current literature shows that TSR leads to a better shoulder function and less pain. The decision on whether to perform a TSR or HHR should be guided by the individual pathology. The final treatment should be reliable in terms of a better shoulder function, reduced pain, and good strength. The role of glenoid loosening in TSR and its impact on shoulder function in the long term remains uncertain and has to be clarified in the future.