total shoulder arthroplasty is associated with less pain and better functional outcomes, but humeral head resurfacing may be preferred in younger, higher demand patients: a short-term outcomes study in patients with glenohumeral osteoarthritis

Objectives: this study aimed to compare short-term outcomes following total shoulder arthroplasty (tsa) and humeral head resurfacing (hhr) in patients with glenohumeral osteoarthritis (ghoa).methods: a retrospective analysis included patients who had undergone either tsa or hhr for ghoa at a single institution. baseline demographics, complications, range of motion (active forward flexion, ff and active external rotation, er), visual analog scores (vas), and subjective shoulder values (ssv) were collected.results: a total of 69 tsa and 56 hhr patients were analyzed. more hhr patients were laborers (44% versus 21%, p=0.01). there were more smokers in the tsa group (25% versus 11%, p=0.04) and more cardiovascular disease in the hhr cohort (64% versus. 6%, p<0.0001). postoperative ff was similar, but er was greater in the hhr (47° ± 15°) vs. tsa group (40° ± 12°, p = 0.01). vas was lower after tsa vs. hhr (median 0, iqr 1 versus median 3.7, iqr 6.9, p<0.0001), and ssv was higher after tsa (89% ± 13% vs. 75% ± 20% after hhr; p<0.0001). post-operative impingement was more common after hhr (32% vs. 3% for tsa, p<0.0001). all other complications were equivalent.conclusion: while younger patients and heavy laborers had improved er following hhr, their pain relief was greater after tsa. decisions on surgical technique should be based on patient-specific demographic and anatomic factors. level of evidence: iii