Shoulder resurfacing arthroplasty is a bone conserving option for patients with glenohumeral arthritis. We report the early results of this procedure at our unit with a minimum follow up of 2 years (mean follow up of 36 months).

A historical analysis of prospectively collected clinical data was reviewed on a consecutive series of 22 patients (mean age of 73 years) with end stage gleno-humeral arthrosis who had undergone humeral resurfacing hemiarthroplasty performed by a single surgeon. Pain and function were assessed using the Oxford shoulder score and patient satisfaction was recorded. Radiographs were evaluated for implant loosening.

82% of patients had significant improvement in their oxford shoulder score from pre-operatively to two years post-operatively. Complications included one case of intra-operative conversion to a stemmed hemiarthroplasty due to fracture of the humeral head, one case of adhesive capsulitis that required MUA and arthroscopic capsular release and two cases of revision to a total shoulder replacement for pain. Humeral resurfacing arthroplasty is a viable treatment option for glenohumeral arthritis with good short term results.

Introduction

The aim of the study was to compare and contrast the clinical outcome of conversion of practice of a shoulder surgeon from open to arthroscopic shoulder stabilisation for traumatic anterior shoulder instability.

The Copeland Shoulder Arthroplasty is a cementless, pegged humeral head surface replacement. The design is based on the principle of minimal bone resection and has been in clinical use since 1986. The only published series to date, that of Levy and Copeland, reported results for 103 patients which were comparable to those obtained with stemmed implants. We report the outcome at our institution using the same prosthesis with a hydroxyapatite coating.

81 shoulders (74 patients) underwent resurfacing hemiarthroplasty through an anterior deltopectoral approach. Preoperative diagnoses were: osteoarthritis (39), rheumatoid arthritis (29), rotator cuff arthropathy (1), post-traumatic arthrosis (2). They were followed for an average 28 months. 10 were lost to follow-up (8 deaths).

Constant scores improved from a mean preoperative figure of 15.7 to 54.0 (p< 0.01) at last follow-up. For rheumatoid arthritis and osteoarthritis the scores improved from 15.2 to 50.4 (p< 0.01) and 16.0 to 55.4 (p,< 0.01) respectively.

There was a 13% complication rate with one case requiring revision for loosening to a stemmed implant. Most were cases requiring subsequent acromioplasty. In one case the glenoid rim was fractured during head dislocation. There was a low rate of perioprosthetic radiolucency (4.2%) which may relate to the hydroxyappatite coating within the shell of the prosthesis. Ipsilateral stemmed elbow replacement was performed in some cases without a double stress riser effect. Periprosthetic humeral neck fracture as managed non-operatively with uneventful union.

Conclusion: The good outcome reported in Copeland’s own series has been replicated in the early to medium term at our institution. The surface replacement system is simpler, accurate and preserves bone stock.

The purpose of this study was to look at the results of using the Copeland surface replacement in the treatment of arthritis of the shoulder.

We report the results of 61 Type 3 Copeland surface replacements in 57 patients. Operations were performed in 33 cases of Rheumatoid Arthritis, 27 cases of Osteoarthritis and 1 case of posttraumatic arthritis. Hemiar-throplasty was performed via a Deltopectoral approach by the senior author in all cases. There were 38 females and 19 males with a minimum follow up of 1 year and a mean follow up of 26 months (range 12–65). Patients were scored pre and post operatively using the Constant score. Average pre-op score was 15.6 and post-operatively was 52.5. There was one case of loosening ( ? secondary to infection) requiring revision to a stemmed implant. Two patients required Sub-Acromial decompression for postoperative impingement. All patients considered their shoulder improved following this procedure. There was no evidence of radiolucency in any postoperative radiograph.

Cementless surface replacement arthroplasty in our series show similar results to previously reported series of stemmed implants and to the published results available for this implant.