Ream and Run Hemiarthroplasty Versus Total Shoulder Arthroplasty: A Comparison of Shoulder Treatments for Glenohumeral Arthritis

Glenohumeral arthritis is commonly managed by total shoulder arthroplasty (TSA), but risks of TSA failure due to its prosthetic glenoid component raise serious concerns, prompting some patients to turn to the ream and run technique (RnR) as an alternative procedure that avoids such complications. This systematic review and meta-analysis compared clinical outcomes of patients who underwent TSA or RnR treatment for glenohumeral arthritis. A total of 668 shoulders from a total of 666 patients were included, with 325 shoulders undergoing RnR and 343 shoulders undergoing TSA. Significant postoperative improvements in simple shoulder test (SST) score (RnR: 4.99, TSA: 4.51), American Shoulder and Elbow Surgeons (ASES) score (RnR: 40.50, TSA: 40.22), external rotation (RnR: 21.22º, TSA: 19.72º), and forward elevation (RnR: 24.75º, TSA: 40.50º) were found in both cohorts. A significant reduction in visual analog scale (VAS) pain score (RnR: -4.08, TSA: 3.93) was also found in both cohorts. Meta-analysis demonstrated no statistically significant difference between treatments across every outcome measure of the study. Both RnR and TSA techniques significantly improve pain and increase functionality and mobility in patients with glenohumeral arthritis. These findings have significant implications for clinical practice moving forward, as they offer clinicians and patients an additional treatment option with comparable outcomes.