Results and limitations of humeral head resurfacing: 105 cases at a mean follow-up of 5 years.
The objective of this study was to assess clinical and computed-tomography (CT) outcomes at least 2 years after humeral head resurfacing to treat concentric gleno-humeral osteoarthritis.



Humeral head resurfacing provides similar outcomes to those achieved with stemmed humeral head implants.



This single-centre retrospective study included 40 Copeland™ and 65 Aequalis™ humeral resurfacing heads implanted between 2004 and 2012. Mean patient age at diagnosis was 64 years. The diagnoses were osteoarthritis with an intact (68%) or torn (21%) rotator cuff, avascular necrosis (5%), osteoarthritis complicating chronic instability (3%), post-traumatic osteoarthritis (2%), and chronic inflammatory joint disease (1%). Validated clinical scores, radiographs, and CT before surgery and at last follow-up were compared.



During the mean follow-up of 56 months, complications occurred in 24 implants. Revision surgery with reverse shoulder replacement was required in 18 cases, after a mean of 43.6 months, to treat glenoid wear or a rotator cuff tear. At last follow-up, for the implants that did not require revision surgery, the mean Constant score was 64/100. The implants had a mean varus of 5° and mean retroversion of -13.3°. The mean increase in glenoid cavity depth was 2.4mm. Mean increases in medial and lateral humeral offset were 1.9mm and 2.7mm, respectively. Pre-operative factors significantly associated with failure were rotator cuff tear (P=0.017) and glenoid erosion (P=0.001).



We found a high failure rate related to glenoid wear or progressive rotator-cuff impairment, although CT showed no evidence of implant malposition or overstuffing. Previous studies of stemmed humeral head implants showed better outcomes. Given the low medium-term prosthesis survival rate, we now reserve humeral head resurfacing for concentric osteoarthritis without glenoid erosions or rotator cuff damage.



IV, retrospective study.
Service d'orthopédie A, Hôpital Roger Salengro, CHRU Lille, rue Emile Laine, 59000 Lille, France. Electronic address: ksoudy@gmail.com.
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Soudy
Service d'orthopédie A, Hôpital Roger Salengro, CHRU Lille, rue Emile Laine, 59000 Lille, France.
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Szymanski
Service d'orthopédie A, Hôpital Roger Salengro, CHRU Lille, rue Emile Laine, 59000 Lille, France.
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Lalanne
Service d'orthopédie A, Hôpital Roger Salengro, CHRU Lille, rue Emile Laine, 59000 Lille, France.
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Bourgault
Service d'orthopédie A, Hôpital Roger Salengro, CHRU Lille, rue Emile Laine, 59000 Lille, France.
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Thiounn
Service d'imagerie ostéo-articulaire, Hôpital Roger Salengro, CHRU Lille, rue Emile Laine, 59000 Lille, France.
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Cotten
Service d'orthopédie A, Hôpital Roger Salengro, CHRU Lille, rue Emile Laine, 59000 Lille, France.
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Maynou
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D061165:Glenoid Cavity / Q000000981:diagnostic imaging; D006801:Humans; D058430:Humeral Head / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000150:complications; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000601:surgery*; D010020:Osteonecrosis / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology*; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000150:complications; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D000072227:Shoulder Prosthesis / Q000009:adverse effects; D014057:Tomography, X-Ray Computed
Humeral head implant; Resurfacing; Shoulder