title: [Cementless humeral head replacement for dislocation arthropathy of the shoulder joint].
abstract: BACKGROUND
  Only a few reports in the literature describe that total shoulder replacement provides better functional results in dislocation arthropathy than hemiarthroplasty. Nevertheless, the risk of aseptic loosening in young and active patients is high after long-term follow-up. We evaluated the results of cementless humeral head resurfacing in this group.
  
  
  METHODS
  We evaluated 29 patients with dislocation arthropathy who had been followed up for a mean of 39 months. The mean age at the time of operation was 43.7±14.7 years. Preoperatively, cuff deficiency was seen in 11 cases.
  
  
  RESULTS
  The mean adjusted Constant score improved from 16.8±15.2% to 78.1±21.9%. Negative prognostic factors turned out to be female sex, age, cuff tears especially of the subscapularis tendon, and previous bone block procedures. Revision was performed in five patients, and two developed painful glenoid erosion which required conversion to total shoulder arthroplasty.
  
  
  CONCLUSIONS
  Cementless humeral head replacement is a viable option in the treatment of dislocation arthropathy. Revision can be performed easily since the bone stock has been preserved. On the basis of our data, humeral head replacement in patients <40 years with dislocation arthropathy offers promising short- to midterm results with an acceptable complication rate.
authors.affiliation: Klinik für Schulterchirurgie, Salzburger Leite 1, 97616, Bad Neustadt/ Saale. birgitwerner@hotmail.com
authors.forename: B S
authors.initials: BS
authors.lastname: Werner
authors.forename: F
authors.initials: F
authors.lastname: Gohlke
mesh_terms: D000328:Adult; D000368:Aged; D001177:Arthropathy, Neurogenic / Q000150:complications* / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000295:instrumentation / Q000379:methods*; D001843:Bone Cements; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058430:Humeral Head / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D012783:Shoulder Dislocation / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001843:Bone Cements
references.citation: J Shoulder Elbow Surg. 2004 May-Jun;13(3):266-71
references.pmid: 15111895
references.citation: J Bone Joint Surg Am. 1998 Jun;80(6):841-52
references.pmid: 9655102
references.citation: J Bone Joint Surg Am. 1990 Sep;72(8):1193-7
references.pmid: 2204630
references.citation: Rev Chir Orthop Reparatrice Appar Mot. 2003 Nov;89(7):580-92
references.pmid: 14699303
references.citation: J Shoulder Elbow Surg. 2001 Nov-Dec;10(6):539-45
references.pmid: 11743532
references.citation: J Shoulder Elbow Surg. 2009 May-Jun;18(3):339-47
references.pmid: 19254851
references.citation: J Bone Joint Surg Am. 2008 Jan;90(1):110-7
references.pmid: 18171964
references.citation: J Bone Joint Surg Am. 1999 Oct;81(10):1357-66
references.pmid: 10535586
references.citation: Rev Chir Orthop Reparatrice Appar Mot. 2000 Oct;86(6):558-65
references.pmid: 11060429
references.citation: J Bone Joint Surg Am. 1983 Apr;65(4):456-60
references.pmid: 6833319
references.citation: J Shoulder Elbow Surg. 1995 Mar-Apr;4(2):87-94
references.pmid: 7600170
references.citation: J Bone Joint Surg Am. 1982 Mar;64(3):319-37
references.pmid: 7061549
references.citation: Am J Sports Med. 2004 Jul-Aug;32(5):1165-72
references.pmid: 15262638
references.citation: J Bone Joint Surg Am. 2002 Oct;84(10):1775-81
references.pmid: 12377907
references.citation: J Bone Joint Surg Br. 2001 Mar;83(2):213-21
references.pmid: 11284568
references.citation: Am J Sports Med. 1995 Sep-Oct;23(5):538-44
references.pmid: 8526267