title: Surface Replacement Arthroplasty of the Humeral Head in Young, Active Patients: Midterm Results.
abstract: BACKGROUND
  The treatment of glenohumeral arthritis in young, active patients remains controversial. Standard total shoulder arthroplasty in this patient group has not obtained the same satisfaction rate as in older patients. One surgical option that has emerged is humeral resurfacing.
  
  
  OBJECTIVE
  Humeral head surface replacement arthroplasty (SRA) would provide satisfactory clinical outcomes in active patients, allowing them to maintain their normal lifestyle without activity restrictions.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  From 2004 to 2007, all consecutive surface replacement arthroplasties of the humerus performed at the authors' institution were identified and retrospectively reviewed, and 118 patients who underwent SRA during this time were identified. This study included patients younger than 60 years who wished to maintain an active lifestyle; 52 of the 118 patients met the inclusion criteria. University of California at Los Angeles (UCLA) shoulder scores and subjective shoulder value (SSV) scores were used to measure clinical outcomes at an average follow-up of 6 years (range, 4-8 years). Of the 52 patients meeting the inclusion criteria, 48 were contacted and examined for the study, with 4 patients lost to follow-up.
  
  
  RESULTS
  The mean postoperative UCLA score was 28.03, with 1 patient requiring revision because of pain and glenoid wear. The mean SSV was 92% (range, 0%-100%), with 3 patients restricting their activity because of the shoulder. Forty-seven of the 48 contacted patients stated that, given the option, they would have the same surgery again. One patient required revision surgery because of pain.
  
  
  CONCLUSIONS
  Surface replacement arthroplasty provided reasonable results in patients younger than 60 years with high activity demands with a low rate of revision at midterm follow-up.
authors.affiliation: Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Iagulli
authors.affiliation: Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, USA.
authors.forename: Larry D
authors.initials: LD
authors.lastname: Field
authors.affiliation: Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, USA.
authors.forename: E Rhett
authors.initials: ER
authors.lastname: Hobgood
authors.affiliation: Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA. ; Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Hurt
authors.affiliation: Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Charles
authors.affiliation: Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Brien
authors.affiliation: Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Felix H
authors.initials: FH
authors.lastname: Savoie
keywords: glenohumeral arthritis; humeral head surface replacement; shoulder arthritis; surface replacement arthroplasty; young patients