Sanchez-Sotelo, J Bone Joint Surg Am 2001 - Shoulder Hemiarthroplasty for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency

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Shoulder Hemiarthroplasty for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency

Sanchez-Sotelo, Rowland, et al.·J Bone Joint Surg Am·2001·238 citations·Retrospective cohort

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Background

Hemiarthroplasty for the treatment of shoulders with glenohumeral arthritis and severe rotator cuff deficiency has been reported to provide reasonable clinical results. The purposes of this study were to determine the clinical and radiographic results of hemiarthroplasty for this condition and to identify pathological and technical factors that may influence its outcome.

Methods

30 patients (33 shoulders) managed with hemiarthroplasty because of glenohumeral arthritis and a massive, irreparable tear of the rotator cuff were followed for an average of 5 years (range, 2 to 11 years).
8 shoulders had undergone a prior acromioplasty and resection of the coracoacromial ligament.
A small prosthetic head was used in 3 shoulders; a medium head, in 26; and a large head, in 4.
Clinical results were graded according to the limited-goals criteria of Neer et al.

Results

The mean pain score decreased from 4.2 points preoperatively to 2.2 points at the time of the most recent follow-up (p = 0.0001).
However, at the time of the most recent follow-up, 9 shoulders (27%) had moderate pain at rest (4 shoulders) or pain with activity (5 shoulders).
Mean active elevation improved from 72 degrees (range, 30 degrees to 150 degrees) to 91 degrees (range, 40 degrees to 165 degrees) (p = 0.008).
Anterosuperior instability occurred in 7 shoulders and was associated with a history of subacromial decompression (p = 0.04).
The result was graded as successful for 22 shoulders (67%).

Conclusions

Shoulder hemiarthroplasty provides marked pain relief in three-quarters of patients with glenohumeral arthritis and severe rotator cuff deficiency. It is a reconstructive option that provides durable results, but it may be complicated by instability and progressive bone loss.

Copyright remains with the authors and publisher.

Shoulder Hemiarthroplasty for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency.

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Shoulder Hemiarthroplasty for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency

Sanchez-Sotelo, Rowland, et al.·J Bone Joint Surg Am·2001·238 citations·Retrospective cohort

|

Background

Hemiarthroplasty for the treatment of shoulders with glenohumeral arthritis and severe rotator cuff deficiency has been reported to provide reasonable clinical results. The purposes of this study were to determine the clinical and radiographic results of hemiarthroplasty for this condition and to identify pathological and technical factors that may influence its outcome.

Methods

30 patients (33 shoulders) managed with hemiarthroplasty because of glenohumeral arthritis and a massive, irreparable tear of the rotator cuff were followed for an average of 5 years (range, 2 to 11 years).
8 shoulders had undergone a prior acromioplasty and resection of the coracoacromial ligament.
A small prosthetic head was used in 3 shoulders; a medium head, in 26; and a large head, in 4.
Clinical results were graded according to the limited-goals criteria of Neer et al.

Results

The mean pain score decreased from 4.2 points preoperatively to 2.2 points at the time of the most recent follow-up (p = 0.0001).
However, at the time of the most recent follow-up, 9 shoulders (27%) had moderate pain at rest (4 shoulders) or pain with activity (5 shoulders).
Mean active elevation improved from 72 degrees (range, 30 degrees to 150 degrees) to 91 degrees (range, 40 degrees to 165 degrees) (p = 0.008).
Anterosuperior instability occurred in 7 shoulders and was associated with a history of subacromial decompression (p = 0.04).
The result was graded as successful for 22 shoulders (67%).

Conclusions

Shoulder hemiarthroplasty provides marked pain relief in three-quarters of patients with glenohumeral arthritis and severe rotator cuff deficiency. It is a reconstructive option that provides durable results, but it may be complicated by instability and progressive bone loss.

Copyright remains with the authors and publisher.

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