Abstract
Introduction
The treatment of glenohumeral arthritis in a young patient poses a significant challenge. Factors that affect decision making include higher activity levels, greater expectations, and concerns of implant longevity. Conflicting results have been reported in the literature. The purpose of this study is to report on our results for resurfacing of the humeral head combined with a biologic glenoid resurfacing using a soft tissue allograft for the treatment of glenohumeral osteoarthritis.
Methods
From 2003 to 2009 a retrospective multi-center review of 15 humeral and biologic glenoid resurfacing procedures with a mean age of 36.5 yrs. was performed. Indications for surgery included a diagnosis of glenohumeral arthritis non-responsive to conservative treatment. Exclusion criteria included major glenoid osseous deficiency, advanced rheumatoid arthritis, and chronic infection.
Results
Mean follow-up of 57.1 months showed that on average active forward elevation improved from 126.8° to 136° and external rotation improved from 27.1° to 35.3°. The mean pre-operative and post-operative VAS score only improved from 7.9 to 5.1. Five (29%) patients were converted a total shoulder arthroplasty (TSA) at an average of 24 months with no complications in the remaining patients.
Discussion
The clinical outcome of humeral head resurfacing with soft tissue resurfacing of the glenoid has not yielded encouraging results, as both pain and function are not significantly improved. Due to the disappointing results of this procedure and high revision rate, it is no longer these authors primary treatment option for OA in the young. Determining the optimal treatment for osteoarthritis in the young patient is still being investigated.
