Abstract
BACKGROUND: Conversion to hemiarthroplasty is occasionally performed as a salvage option in patients with failed total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA) when further revision to RSA is not feasible. This Systematic review and meta-analysis aims to evaluate the functional and clinical outcomes and complication rates of revision to shoulder hemiarthroplasty. METHODS: A systematic review was conducted according to PRISMA guidelines, with searches performed in PubMed, Embase, and Cochrane databases up to January 2024. Studies reporting functional outcomes, pain scores, range of motion, complication rates, or revision rates following conversion of failed TSA or RSA to hemiarthroplasty, with ≥24 months follow up, were included. RESULTS: Thirteen studies comprising 211 patients met inclusion criteria. Pain scores improved significantly postoperatively (mean difference 2.57 points on a 10-point scale, p < 0.0001). Functional scores increased by a mean of 16.83 points (on a 100-point scale, p = 0.01). Overall patient satisfaction was reported in seven studies, with 58% of patients satisfied. The reoperation rate was 16.1%. CONCLUSION: Hemiarthroplasty offers a viable salvage option for failed TSA or RSA in patients unsuitable for complex revision surgery. While functional gains are modest and range of motion improvement is limited, pain relief and preservation of bone stock support its role in selected revision scenarios.