title: A quantitative method for determining medial migration of the humeral head after shoulder arthroplasty: preliminary results in assessing glenoid wear at a minimum of two years after hemiarthroplasty with concentric glenoid reaming.
abstract: OBJECTIVE
  Glenoid erosion and medial migration of the humeral head prosthesis have been observed after most types of shoulder arthroplasty. A method of measuring the change in humeral head position with time after shoulder prosthetic arthroplasty was applied it to 14 shoulders that underwent humeral hemiarthroplasty with concentric glenoid reaming. We hypothesized that the measurement technique would be reproducible and that the rate of wear would be small in the series of shoulders studied.
  
  
  METHODS
  Standardized anteroposterior and axillary radiographs were obtained after surgery. Two examiners measured the position of the humeral head center in relation to scapular reference coordinates for the anteroposterior and axillary projections and plotted these values against time after surgery. The change in position was characterized as the slope of this plot. Shoulders were included if there were at least 3 sets of postoperative films, the last being at least 2 years after surgery.
  
  
  RESULTS
  The slopes measured by the 2 examiners agreed within 0.5 mm/y for the anteroposterior and the axillary projections. For the series of shoulder arthroplasties, the rate of movement of the head center toward the scapula was less than 0.4 mm/y for either examiner in either projection.
  
  
  CONCLUSIONS
  Medial migration is a concern after any type of shoulder arthroplasty, whether a hemiarthroplasty, a biological interpositional arthroplasty, or a total shoulder arthroplasty. Quantifying the rate of medial migration over time after shoulder arthroplasty is an important element of clinical follow-up.
  
  
  CONCLUSIONS
  This is an inexpensive, practical, and reproducible method that can be used to determine the rate of medial migration of the humeral head on plain radiographs after shoulder arthroplasty. The average rate of medial migration in the shoulders in this study was small.
authors.affiliation: Department of Orthopedics and Sports Medicine, University of Washington Medial Center, Seattle, WA 98195, USA.
authors.forename: Deana M
authors.initials: DM
authors.lastname: Mercer
authors.forename: Brian B
authors.initials: BB
authors.lastname: Gilmer
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Saltzman
authors.forename: Alexander
authors.initials: A
authors.lastname: Bertelsen
authors.forename: Winston J
authors.initials: WJ
authors.lastname: Warme
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Matsen
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging*; D006801:Humans; D058430:Humeral Head; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D012785:Shoulder Joint / Q000601:surgery*