title: Humeral surface replacement for osteoarthritis.
abstract: OBJECTIVE
  Humeral resurfacing has shown promising results for osteoarthritis, but revisions for glenoid erosion have been reported frequently. We investigated the hypothesis that preoperative glenoid wear and postoperative progress of glenoid erosion would influence the clinical outcome.
  
  
  METHODS
  We reviewed 61 resurfacing hemiarthroplasties (55 patients) for primary osteoarthritis. 6 patients were lost to follow-up and 5 had undergone revision arthroplasty. This left 50 shoulders in 44 patients (mean age 66 years) that were followed for mean 30 (12-44) months. Complications, revisions, and the age- and sex-related Constant score were assessed. Radiographs were evaluated for loosening and glenoid erosion according to Walch.
  
  
  RESULTS
  Of the 50 shoulders that were functionally assessed, the average age- and sex-related Constant score was 73%. In patients with preoperative type-B2 glenoids, at 49% it was lower than in type-A1 glenoids (81%, p = 0.03) and in type-B1 glenoids (84%, p = 0.02). The average age- and sex-related Constant score for patients with type-A2 glenoids (60%) was lower than for type-A1 and -B1 glenoids and higher than for type-B2 glenoids, but the differences were not statistically significant. In the total population of 61 shoulders, the radiographs showed postoperative glenoid erosion in 38 cases and no humeral prosthetic loosening. Revision arthroplasty was performed in 11 cases after 28 (7-69) months. The implant size had no statistically significant influence on the functional outcome. The size was considered to be adequate in 28 of the 50 functionally assessed shoulders. In 21 cases, the implant size was too large and in 1 case it was too small.
  
  
  CONCLUSIONS
  We found frequent postoperative glenoid erosion and a high rate of revision arthroplasty after humeral resurfacing for primary osteoarthritis. Oversizing of the implants was common, but it had no statistically significant influence on the functional outcome. Inferior results were found in the presence of increased eccentric preoperative glenoid wear. Total shoulder arthroplasty should be considered in these patients.
authors.affiliation: Shoulder, Knee, and Sports Medicine , Orthopaedic Clinic of Hanover Medical School at the Annastift Hospital, Hanover , Germany .
authors.forename: Tomas
authors.initials: T
authors.lastname: Smith
authors.forename: Andre
authors.initials: A
authors.lastname: Gettmann
authors.forename: Mathias
authors.initials: M
authors.lastname: Wellmann
authors.forename: Frederic
authors.initials: F
authors.lastname: Pastor
authors.forename: Melena
authors.initials: M
authors.lastname: Struck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D062785:Hemiarthroplasty / Q000379:methods* / Q000534:rehabilitation; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012785:Shoulder Joint; D016896:Treatment Outcome
references.citation: J Shoulder Elbow Surg. 2004 May-Jun;13(3):266-71
references.pmid: 15111895
references.citation: Arch Orthop Trauma Surg. 2013 May;133(5):615-9
references.pmid: 23494113
references.citation: J Bone Joint Surg Am. 2006 Dec;88(12):2637-44
references.pmid: 17142414
references.citation: Clin Orthop Relat Res. 2004 Apr;(421):120-5
references.pmid: 15123936
references.citation: J Bone Joint Surg Am. 2008 Jan;90(1):110-7
references.pmid: 18171964
references.citation: J Shoulder Elbow Surg. 2011 Jul;20(5):771-7
references.pmid: 21106400
references.citation: J Bone Joint Surg Am. 2000 Jan;82(1):26-34
references.pmid: 10653081
references.citation: J Arthroplasty. 1990 Dec;5(4):329-36
references.pmid: 2290089
references.citation: Arch Orthop Trauma Surg. 2008 Apr;128(4):347-54
references.pmid: 17638000
references.citation: J Arthroplasty. 1999 Sep;14(6):756-60
references.pmid: 10512449
references.citation: J Bone Joint Surg Am. 1983 Apr;65(4):456-60
references.pmid: 6833319
references.citation: J Bone Joint Surg Br. 1997 Jul;79(4):695-6
references.pmid: 9250770
references.citation: Am J Orthop (Belle Mead NJ). 2007 Dec;36(12 Suppl 1):4-8
references.pmid: 18264550
references.citation: J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):431-41
references.pmid: 12378161
references.citation: J Shoulder Elbow Surg. 2005 Sep-Oct;14(5):485-91
references.pmid: 16194739
references.citation: J Bone Joint Surg Am. 1998 Apr;80(4):464-73
references.pmid: 9563375
references.citation: J Bone Joint Surg Am. 2009 May;91(5):1228-38
references.pmid: 19411474
references.citation: J Shoulder Elbow Surg. 1997 Sep-Oct;6(5):449-54
references.pmid: 9356934
references.citation: J Bone Joint Surg Am. 2007 Aug;89(8):1756-62
references.pmid: 17671015
references.citation: Arch Orthop Trauma Surg. 2004 Jul;124(6):366-73
references.pmid: 15133697
references.citation: J Bone Joint Surg Br. 2010 Oct;92(10):1403-9
references.pmid: 20884979
references.citation: J Shoulder Elbow Surg. 2013 May;22(5):612-9
references.pmid: 23149276
references.citation: Z Orthop Unfall. 2008 Mar-Apr;146(2):206-10
references.pmid: 18404584
references.citation: Clin Orthop Relat Res. 1987 Jan;(214):160-4
references.pmid: 3791738
references.citation: Clin Orthop Relat Res. 2010 Aug;468(8):2122-8
references.pmid: 20232183
references.citation: J Bone Joint Surg Br. 2001 Mar;83(2):213-21
references.pmid: 11284568
references.citation: Int Orthop. 2009 Apr;33(2):451-6
references.pmid: 18092162
references.citation: J Bone Joint Surg Am. 2004 Mar;86(3):512-8
references.pmid: 14996876
references.citation: Acta Orthop Scand. 2000 Apr;71(2):180-4
references.pmid: 10852325
references.citation: J Shoulder Elbow Surg. 2007 Jul-Aug;16(4):396-402
references.pmid: 17582789
references.citation: J Bone Joint Surg Am. 2006 Apr;88(4):900-5
references.pmid: 16595483