Tuesday, August 8, 2017

Is humeral resurfacing a conservative treatment for primary arthritis?

Outcome and revision rate of uncemented glenohumeral resurfacing (C.A.P.) after 5–8 years

These authors report the mid-term results of an uncemented resurfacing shoulder prosthesis in patients with primary osteoarthritis having surgery from January 2007 to December 2009. No glenoid arthroplasty was used in these patients.

Forty-six patients (12 males) with a mean age of 72 years old (range 59–89) were included. At a mean 6.4-year follow-up (range 5–8), the Constant Score, visual analog pain scale and the Dutch Simple Shoulder Test scores improved significantly (p < 0.05) from baseline.

 Eleven patients (23%) had a revision operation.


They compared their revision rate to that in prior publications
Comment: We're often asked whether a resurfacing hemiarthroplasty is a conservative option for the management of glenohumeral arthritis. As demonstrated by this study, the issue with the resurfacing hemiarthroplasty appears to be the fact that it does not address the glenoid aspect of glenohumeral arthritis. These authors did not seem to have problems with fixation of the humeral component, but rather most of the problems related to glenoid erosion.
While it may seem simple to combine a resurfacing with a glenoid component, experience has shown that the retention of the humeral anatomic neck can interfere with good access to the glenoid, compromising the ability to perform a technically excellent prosthetic glenoid arthroplasty.
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