Abstract
Biologic resurfacing of the glenoid combined with surface replacement hemiarthroplasty for relatively young patients suffering from advanced glenohumeral arthritis has the advantages of both humeral head and glenoid bone preservation. The longer term results of this procedure are reported.
Twenty two shoulders in 21 patients had a surface replacement hemiarthroplasty with resurfacing of the glenoid with the anterior capsule. At follow up one had died, and another was not contactable. The prosthesis was removed in one for deep infection, and the fourth patient had undergone revision to a total shoulder arthroplasty for ongoing pain. Therefore, 17 patients with 18 operated shoulders were available for clinical assessment. The average age of the patients was 54.8 years (35–78) at the time of surgery.
The average length of follow-up was 4.8 years (2–10.6). The average Constant Score was 71.4 points (41–95), and the sex- and age-adjusted Constant Score was 83.9%. The mean ASES score was 74.4 points (35–100). The average arc of forward flexion was 130 degrees (100–160), and external rotation was 39 degrees (20–60). On a VAS scale of 0 to 10, the average pain score at rest was 0.5 (0–3), while pain with activity was 2.4 (0–6). Sixteen of the 17 patients (94%) had a satisfactory result, and would have the operation again. Eight of the 17 patients (47%) were able to return to their previous sporting activities. Radiographic follow-up demonstrated there were 2 mild and 2 moderate cases of superior subluxation of the humeral head. There was no subsidence or signs of loosening of any humeral prosthesis. The average glenohumeral joint space was 0.13mm (0–2). Glenoid erosion was none in one case, mild in 6 cases, moderate in 6 cases, and severe in 3 shoulders.
Although the results of this procedure compare favourably with other series, the extent of glenoid erosion is concerning. A more robust tissue for interposition may give better results
The abstracts were prepared by David AF Morgan. Correspondence should be addressed to him at davidafmorgan@aoa.org.au
Declaration of interest: a
