Abstract
Background
Absence of rotator cuff allows unbalanced muscle forces of the shoulder to cause vertical migration of the humeral head. The translation of the humerus causes impaction of articular surface against the acromion. The purpose of the study is to assess outcome of Cuff tear arthropathy (CTA) Hemiarthroplasty prosthesis in this group of patients.
Methods
Retrospective review was undertaken in 42 patients who underwent Global CTA Hemiarthroplasty between Jan 2001-Jan 2009. The mean length of follow up was 6 years.
Results
The patients at review showed statistically significant improvement in Forward Flexion, Abduction and Numerical Pain Rating. There were four revision surgeries and the overall survival rate at ten years was 89 %.
There was statistically significant improvement (p < 0.05) in forward flexion abduction and Numerical rating scale (p 0.02). Although improvement was noted in external and internal rotation this was not statistically significant.
There was one perioperative humerus fracture which required plating at the same time of surgery. The fracture went on to heal uneventfully. There was also one post-operative haematoma which required arthroscopic washout. One patient underwent further arthroscopic debridement for poor ROM which improved from 20 Abd 20 FF to 90, 90 FF, Abd.
There were four revision surgeries; 3 revisions to reverse geometry replacement; and one patient had removal of implant because of persistant dislocation of implant and patient did not want another major surgery. Patients who required revision had further erosion of acromion and poor ROM of < 20 Abd, FF, and Pain 8–10/10.
Conclusion
This study shows that significant improvement in pain, and movements are achieved with this device. Acromial and glenoid erosion is a potential issue with this prosthesis and three revisions were required for this this problem. The results are better than standard hemiarthroplasty when used in this setting.
