title: Stemmed hemiarthroplasty versus resurfacing in primary shoulder osteoarthritis: a single-center retrospective series of 78 patients.
abstract: BACKGROUND
  Resurfacing shoulder arthroplasty is proposed in primary osteoarthritis of the shoulder. The present study compared resurfacing versus 3rd generation stemmed hemiarthroplasty in terms of survival, functional results and implant positioning effects.
  
  
  METHODS
  Seventy eight patients underwent arthroplasty for primary osteoarthritis of the shoulder: 41 by resurfacing and 37 by stemmed hemiarthroplasty. The two populations were comparable on all baseline variables. Minimum follow-up was 2 years. The principal assessment criterion was survivorship with surgical revision as end-point. Secondary criteria were functional results on Constant, quick-DASH, Neer and SSV scores, and implant positioning effects assessed on radiology.
  
  
  RESULTS
  At a mean 44 months' follow-up (range, 24-118 months), there were no significant differences in functional scores. Radiologic analysis found greater varus positioning and lateral offset of the humeral head in resurfacing compared with stemmed hemiarthroplasty (128° vs 138°, P<0.01; 6.5 ± 2 vs 4.6 ± 1.6mm, P<0.01). Survivorship without revision was significantly poorer in resurfacing, with 4 revision procedures for glenoid wear (9.8%), versus none in hemiarthroplasty (P=0.02). There was no correlation between humeral head size, positioning or lateral offset and revision.
  
  
  CONCLUSIONS
  Revision-free survival was significantly lower in resurfacing than in hemiarthroplasty. Greater humeral head size may increase lateral offset, accelerating glenoid wear. Down-sizing the humeral head in resurfacing procedures might limit these complications.
  
  
  METHODS
  Level III; case-control study.
authors.affiliation: Unité d'orthopédie et traumatologie de Purpan, institut de l'appareil locomoteur, CHU de Toulouse, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Lebon
authors.affiliation: Unité d'orthopédie et traumatologie de Purpan, institut de l'appareil locomoteur, CHU de Toulouse, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Delclaux
authors.affiliation: Unité d'orthopédie et traumatologie de Purpan, institut de l'appareil locomoteur, CHU de Toulouse, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Bonnevialle
authors.affiliation: Unité d'orthopédie et traumatologie de Purpan, institut de l'appareil locomoteur, CHU de Toulouse, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Rongières
authors.affiliation: Unité d'orthopédie et traumatologie de Purpan, institut de l'appareil locomoteur, CHU de Toulouse, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Bonnevialle
authors.affiliation: Unité d'orthopédie et traumatologie de Purpan, institut de l'appareil locomoteur, CHU de Toulouse, place du Dr Baylac, 31059 Toulouse cedex, France. Electronic address: mansat.p@chu-toulouse.fr.
authors.forename: P
authors.initials: P
authors.lastname: Mansat
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Glenoid wear; Hemiarthroplasty; Primary shoulder osteoarthritis; Resurfacing