Comparing revision rates and survival of pyrocarbon and non-pyrocarbon heads in total- and hemi- shoulder arthroplasty.

Objective: This retrospective, observational study aimed to assess the revision rates and survival curves in total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) patients, including a sub analysis to investigate the impact of pyrocarbon humeral head in revision rates.

Methods: Data from 92 primary HSA and 508 primary TSA patients performed by seven surgeons at a large private clinic, were analyzed. The study focused on revision rates and identified factors leading to revisions, including rotator cuff insufficiency, dislocation, aseptic loosening, implant material, and glenoid erosion.

Results: The overall revision rate for HSA was found to be significantly higher at 7.6% compared to TSA at 1.2% with a maximum follow-up of seven years. Sub-analysis within the HSA group revealed a notably higher revision rate in cases involving a metal head (cobalt-chrome or titanium) at 12.8% compared to those with a pyrocarbon head (2.3%).

Conclusion: This study underscores the importance of distinguishing between TSA and HSA when evaluating shoulder arthroplasty outcomes. The significantly higher revision rate in HSA, particularly with metal heads, suggests the need for careful consideration of implant selection to optimize long-term success in shoulder arthroplasty procedures.