These authors identified 60 patients who underwent humeral head hemiarthroplasty for osteoarthritis from November 8, 1978, through January 15, 1997. 44 of these (average age 58 (37-77) years) had a mean follow-up of 17 years (range, 10-30 years).
During the study period, 541 shoulders underwent anatomic total shoulder arthroplasty for osteoarthritis. Hemiarthroplasty was performed for patients who were younger (although 20% were older than 65 years), with higher activity levels, and who had full-thickness cartilage loss over a portion of or the entire glenoid surface with either minimal glenoid erosion or severe central erosion that would compromise glenoid fixation (n = 10). Intraoperatively, 9 shoulders had small to medium rotator cuff tears (all <3 cm in diameter) which were repaired.
Patients experienced significant pain relief postoperatively that was maintained during the longterm follow-up (P < .01), but a subgroup of 11 patients reporting persistent moderate or severe pain.
In the 25 of the original 60 shoulders with 5 years of radiographic follow-up, Kaplan-Meier survival analysis demonstrated moderate to severe glenoid erosion in 50% at 5 years, which increased to 59% at 15 years and 88% at 20 years. The only factor that predicted postoperative glenoid erosion was early age at the time of initial operation
Ten of 44 (22.7%) shoulders underwent revision surgery, predominantly for glenoid arthrosis (n = 9).
Comment: The patients included in this retrospective followup study had a wide range of characteristics. Three different types of implants were used. Nine had rotator cuff tears and the rest apparently did not. While the authors state that hemiarthroplasty was performed for patients who were younger, the age range extended up to 77 years of age at the time of surgery, 9 (20%) were older than 65 years. Six patients had biconcave glenoids. The glenoid surface pathology ranged from a full-thickness cartilage loss over a portion of the glenoid surface to severe central erosion that would compromise glenoid fixation, preluding a total shoulder arthroplasty (n = 10). Since these 10 patients with severe glenoid erosion would be expected to continue to have glenoid erosion after hemiarthroplasty, it would be of interest to know the results if these patients were excluded.
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Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book.
Click here to see the new Rotator Cuff Book
Information about shoulder exercises can be found at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
