Cementless surface replacement arthroplasty of the shoulder with biologic resurfacing of the glenoid

Background

We report a retrospective review of surface replacement hemiarthroplasty of the shoulder with biologic resurfacing of the glenoid, for relatively young patients suffering from advanced glenohumeral arthritis. It was hoped that the resurfacing fascia would prevent glenoid erosion for a period of time.

Methods

This surgery was performed by two surgeons between 1996 and 2005. The indications for the arthroplasty were severe pain and limitation of function, in relatively young patients with advanced glenohumeral arthritis but an intact rotator cuff.

Results

Eighteen shoulders, with an average follow-up of 4.8 years (range 2-10.6), were available for assessment. The average age was 54.8 years. Postoperative Constant-Murley Score averaged 71.4 points; the mean sex- and age-adjusted Constant Score was 83.9%. The mean American Shoulder and Elbow Surgeons score was 74.4 points. Average active forward elevation was 130 degrees. Eighty three percent of the patients were satisfied with the long-term result. Radiographic follow-up demonstrated that none of the prostheses was loose; however moderate to severe glenoid erosion was present in 56% of shoulders.

Conclusions

We conclude that this procedure is useful in the treatment of younger patients suffering from advanced glenohumeral arthritis of the shoulder; however the interposed anterior capsule did not protect the glenoid from mid-term erosion by the humeral prosthesis.

Level of evidence

Level IV, retrospective case series.

Keywords: Shoulder arthritis, shoulder arthroplasty, shoulder surface hemiarthroplasty, glenoid resurfacing, fascial interpositional arthroplasty