title: Shoulder hemiarthroplasty with concentric glenoid reaming in patients 55 years old or less.
abstract: BACKGROUND
  Glenohumeral arthritis in younger individuals is challenging because of the complex pathology, need for extended durability, and high expectations of the patients. Humeral hemiarthroplasty combined with concentric glenoid reaming is a surgical option for the management of glenohumeral arthritis that avoids the risks of glenoid component failure and avoids the challenges of tissue interposition. The results of this procedure in young patients have not been previously reported.
  
  
  METHODS
  Sixty-five shoulders in patients who were 55 years old or less at the time of surgery underwent humeral hemiarthroplasty combined with concentric glenoid reaming and were followed for a minimum of 2 years or until the time of revision surgery. Patient self-assessments of shoulder comfort and function were compared before and after surgery. For 22 of these shoulders, standardized radiographs were available for follow-up evaluation.
  
  
  RESULTS
  Nine shoulders required revision surgery. These shoulders had 3 ± 3 prior surgeries, in comparison to 1 ± 1 prior surgeries for the unrevised group. For the 56 unrevised shoulders, the number of Simple Shoulder Test functions that could be performed improved from a mean of 4.1 before surgery to a mean of 9.5 at an average follow-up of 43 months (range, 24-85) (P < .001). For the 22 shoulders with radiographic follow-up, medial glenoid erosion averaged 1.1 mm (range, 0.0-6.3 mm) at an average of 44 months after the procedure.
  
  
  CONCLUSIONS
  In selected patients 55 years or younger with glenohumeral arthritis, this procedure can provide significant improvement in self-assessed shoulder comfort and function.
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA. matsen@u.washington.edu
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Saltzman
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Chamberlain
authors.forename: Deana M
authors.initials: DM
authors.lastname: Mercer
authors.forename: Winston J
authors.initials: WJ
authors.lastname: Warme
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Bertelsen
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Matsen
mesh_terms: D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D012086:Reoperation; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult