Assessing the Value to the Patient of New Technologies in Anatomic Total Shoulder Arthroplasty.

J Bone Joint Surg Am · May 05 2021 · Review

Schiffman CJ, Prabhakar P, Hsu JE, Shaffer ML, Miljacic L, Matsen FA

Department of Orthopaedics and Sports Medicine, University of Washington, Seattle

Shoulder & Elbow

SUMMARY — THE REDUCTIONDespite newer technologies like CT planning, patient-specific instrumentation, and novel implants, a review of 114 studies found no clear evidence that anatomic total shoulder arthroplasty outcomes have actually improved over 20 years.
Abstract, as published

BACKGROUND: Publications regarding anatomic total shoulder arthroplasty (TSA) have consistently reported that they provide significant improvement for patients with glenohumeral arthritis. New TSA technologies that have been introduced with the goal of further improving these outcomes include preoperative computed tomography (CT) scans, 3-dimensional preoperative planning, patient-specific instrumentation, stemless and short-stemmed humeral components, as well as metal-backed, hybrid, and augmented glenoid components. The benefit of these new technologies in terms of patient-reported outcomes is unknown.

METHODS: We reviewed 114 articles presenting preoperative and postoperative values for commonly used patient-reported metrics. The results were analyzed to determine whether patient outcomes have improved over the 20 years during which new technologies became available.

RESULTS: The analysis did not identify evidence that the results of TSA were statistically or clinically improved over the 2 decades of study or that any of the individual technologies were associated with significant improvement in patient outcomes.

CONCLUSIONS: Additional research is required to document the clinical value of these new technologies to patients with glenohumeral arthritis.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Featured in the 2026-07-27 issue.

← Hormone replacement therapy and complications after primary t…Minimally Invasive Screw Fixation of Olecranon Fractures. →

The Reduction is a free email digest of newly published orthopaedic literature — a handful of new papers in the subspecialties you choose, each summarized like this one. Subscribe free or browse the archive.