(iii) Total shoulder arthroplasty

Total shoulder arthroplasty became established as a treatment of osteoarthritis in the 1970s as a natural evolution of Neer's original monoblock hemiarthroplasty, previously introduced in the 1950s. Since then, a continuous evolution in prosthetic design with the aim of restoring patients' normal anatomy has occurred. Second and third generation prostheses have evolved into the modern anatomical stemmed prosthesis. Novel stemless humeral implants are also currently under evaluation. The common problem of loosening of the glenoid component, limiting the longevity of TSA, has led to a myriad of different glenoid prosthetic designs over the last four decades. However cemented all-polyethylene designs remain the gold standard. The challenges posed by the insertion of glenoid implants in cases with severe bone deformity and the ability to address rotator cuff failure after TSA with platform systems are current areas of research and debate.