Authors' objectives:

The aim of this report is to evaluate the differential effectiveness of shoulder arthroplasty regarding the scientific evidence available, taking into account, not only the results on the effectiveness of the operation, but especially the impact on patient survival.

Authors' results and conclusions: A large proportion of candidates for joint replacement have rheumatism, arthrosis or processes of traumatic origin. Joint replacement in the upper limb has not been as a successful (in terms of survival radiological or symptomatic loosening) and restoration of function, particularly in the shoulder joint, as hip substitution. The complex anatomy of shoulder and elbow joints and the fact that the bones of the upper limb are considerably smaller than those of the lower limb, makes fixation and alignment of a prosthesis difficult. The report aims to select adequate quality of life evaluation scales for all patients in order to improve their life and bring up to date techniques and procedures so that the orthoprosthetic benefit concerning the prosthesis detailed is effective. Such tools must allow assessment of the benefit in terms of effectiveness and efficiency. These scales bring us pre- and post-operative operation information which allow the development of specifications for improved designs of prostheses and the development of new protocols for placement and surgical techniques.

Authors' recommendations: The articles selected show the results of the studies about shoulder arthroplasty. Although most of the articles render clinical relevance they do not reach significance in some patients. Shoulder arthroplasty is recommended when there is a problem in the shoulder related to a loss of functionality in the glenohumeral joint. It is necessary to revise the design of new studies and to use similar scales of quality of life, in order to improve the evaluation and comparison among series of patients. The scales, meticulously planned and the duration of the prosthesis evaluated suggest that it is necessary to extend the time of prosthesis use to offer consistent results that can provide relevant data for health policy considerations and to direct further studies about new forthcoming models and procedures.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.isciii.es/aets/

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias