SHOULDER SURFACE REPLACEMENT ARTHROPLASTY FOR PATIENTS WITH DEGENERATIVE ARTHRITIS AND WITH ROTATOR CUFF ARTHROPATHY; CLINICAL AND RADIOLOGICAL EVALUATIONS OF FIFTY PATIENTS.

Abstract

Purpose: The purpose of the study was to evaluate the clinical and radiological results of Copeland cementless surface replacement arthroplasty (CSRA) applied in patients with two main indications.

Patients and Methods: The study was conducted on fifty shoulders in fifty patients between 2003 and 2005; 17 patients suffered from rotator cuff pathology. The patients were prospectively followed up clinically and radiologically for a mean of 12.7 months (range, 6–30 months). There were 30 female and 20 male shoulders. The mean age was 66.63 years (range, 21–85). The mean operative time was 44.6 minutes (range, 29–62 minutes). The clinical assessment was performed with the Constant score

Results: The constant score significantly improved from a mean of 15.52 points preoperatively to 57.02 points postoperatively. Of the patients, 96% considered the shoulder to be much better or better as a result of the operation. The Constant-Score improved in the group with degenerative arthritis from 16.32 point pre- to 62.25 postoperatively. In rotator cuff arthropathy the score improved from 14.19 to 53.06.

Radiologically, the humeral offset, the lateral gleno-humeral offset (coracoid base to the greater tuberosity) as well as the acromiohumeral distance were significantly increased. No intra-or postoperative complications encountered.

Conclusion: We conclude that the shoulder surface replacement arthroplasty allows good conservation of the bone stock and avoiding the complications encountered with the stemmed prostheses. In patients with rotator cuff arthropathy there are two main indications:

• - patients below the age of 70, in order to avoid complications of the reverse prosthesis

• - patients with still a goof active range of motion