[Cementless humeral surface replacement arthroplasty in patients less than 55 years of age].
BACKGROUND
Cementless humeral surface replacement arthroplasty is a viable treatment option for degenerative diseases of the shoulder joint. The aim of this prospective study was to analyse the results of this treatment option in patients younger than 55 years of age with different pathologies of the shoulder.


METHODS
Twenty-three patients (26 implants) treated with cementless humeral surface replacement arthroplasty were included in this study. Mean follow-up was 2.5 years (1-6 years). Ten patients had posttraumatic osteoarthritis, seven had primary osteoarthritis, and six had osteonecrosis. Patients were evaluated using the Constant score, shoulder motion, and subjective satisfaction.


RESULTS
The mean Constant score increased significantly from 33 points preoperatively (8-69 points) to 61 points postoperatively (25-83 points; p<0.0001), adjusted to age and gender from 38% (8-86%) to 70% (28-114%; p<0.0001). Significant improvement for the whole cohort was found regarding patients' pain, activity, mobility, shoulder flexion and abduction, and internal and external rotation (p<0.001). In one case, reoperation was necessary due to a superficial wound infection, and in another case, implant revision to a total shoulder replacement was performed because of glenoid erosion.


CONCLUSIONS
Cementless humeral surface replacement arthroplasty is a viable bone-preserving treatment option for young and active patients. Later conversion to total shoulder replacement is possible. Good clinical results, a low complication rate, and high patient satisfaction were found in the short and mid term. Long-term investigations are necessary to confirm these observations.
Raiss
P
P
Sektion Obere Extremität: Schulter-, Ellenbogen- und Handchirurgie, Stiftung Orthopädische Universitätsklinik, Schlierbacher Landstrasse 200 A, 69118, Heidelberg, Deutschland. Patric.Raiss@ok.uni-heidelberg.de
Pape
G
G
Becker
S
S
Rickert
M
M
Loew
M
M
D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000601:surgery; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*