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I've been told by one orthopedic surgeon that a hemiarthroplasty is the way to go in treating my shoulder arthritis. But when I went for a second opinion, I was advised to just have the whole shoulder joint replaced. What are your thoughts on this?

Orthopedic surgeons continue to seek evidence to guide all aspects of patient care. In a newly released document, the American Academy of Orthopaedic Surgeons (AAOS) offers 16 guidelines for clinical practice in the care of patients with shoulder osteoarthritis. There is a wide range of issues related to shoulder arthritis. The fact that the shoulder joint can be replaced with a joint replacement (implant) has changed the way patients are treated. Younger patients with shoulder arthritis has helped push the envelop so-to-speak, meaning the search is on for the right treatment for all ages. Every day surgeons around the world weigh the pros and cons for the treatment of their patients' painful shoulder arthritis. Patient factors such as age, occupation, severity of symptoms, general health, and education level are taken into consideration when choosing a treatment path. The surgeon's examination and X-ray findings also provide important information when forming the plan of care. Hemiarthroplasty (replacement of part of the joint) has good results but total shoulder replacement still seems to work better for the diagnosis of shoulder osteoarthritis. Many patients who receive a hemiarthroplasty end up having a second surgery to convert to a complete joint replacement. There is general agreement that patients who have a torn rotator cuff are not good candidates for shoulder replacement. Other factors that must be taken into consideration when choosing the best plan of care for yourself include age, occupation, severity of symptoms, general health, and education level. The surgeon's examination and X-ray findings also provide important information when forming the plan of care. These are not quick and easy decisions. Getting a second opinion is a good idea. When the two opinions don't match, a third opinion might help.

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