Cementless humeral resurfacing arthroplasty in active patients less than fifty-five years of age.
BACKGROUND
Cementless humeral resurfacing arthroplasty is a bone-conserving arthroplasty option for patients with glenohumeral arthritis. It has been successful in the older patient population. However, data regarding the results of arthroplasty in younger, more active patients are lacking. We report the two-year results of this procedure in active patients who were less than fifty-five years of age.


METHODS
We reviewed prospectively collected clinical data on a series of thirty-six patients under fifty-five years of age with end-stage glenohumeral arthrosis, but without osteonecrosis, who had undergone a cementless humeral resurfacing hemiarthroplasty performed by a single surgeon. All patients were followed for a minimum of two years. We assessed pain, function, and patient satisfaction and documented all complications. Radiographs were evaluated for implant loosening.


RESULTS
The thirty-six patients had a mean age of 42.3 years and were followed for a mean of 38.1 months. Scores measured with a visual analog pain scale, the Single Assessment Numeric Evaluation (SANE) scale, and the American Shoulder and Elbow Surgeons (ASES) scale all improved significantly from preoperatively to two years postoperatively (p < 0.001). Complications included one traumatic subscapularis rupture at six weeks, three cases of arthrofibrosis, and one deep hematoma. No obvious radiographic evidence of loosening was noted at the time of the latest follow-up. One shoulder was converted to a stemmed total shoulder arthroplasty at twenty-four months because of pain, but the implant was not loose at the revision. The remaining thirty-five patients were satisfied with the outcome at the time of the latest follow-up and had returned to their desired activity.


CONCLUSIONS
Cementless humeral resurfacing arthroplasty is a viable treatment option for younger, active patients. Early results indicate that the desired function and pain relief can be expected. Implant loosening and glenoid wear do not appear to be concerns in the short term despite the high activity levels of many patients. Long-term follow-up is needed to determine if these results persist.
Bailie
David S
DS
The Orthopedic Clinic Association, 9377 East Bell Road, Suite 231, Scottsdale, AZ 85260, USA. david.bailie@dcranch.com
Llinas
Paulo J
PJ
Ellenbecker
Todd S
TS
D000328:Adult; D001168:Arthritis / Q000175:diagnosis / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods*; D001843:Bone Cements; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D011336:Probability; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000175:diagnosis / Q000209:etiology; D016896:Treatment Outcome
D001843:Bone Cements