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Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
Oct, 2019;27 (10): 3203-3211.

Humeral head resurfacing is associated with less pain and clinically equivalent functional outcomes compared with stemmed hemiarthroplasty at mid-term follow-up.

Mitchell S Fourman, Andrea Beck, Gregory Gasbarro, James J Irrgang, Mark W Rodosky, Albert Lin
Author Information
  1. Mitchell S Fourman: School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  2. Andrea Beck: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  3. Gregory Gasbarro: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  4. James J Irrgang: Department of Orthopaedic Surgery and Department of Physical Therapy, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  5. Mark W Rodosky: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  6. Albert Lin: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. LinA2@upmc.edu.
PMID: 30915512 DOI: 10.1007/s00167-019-05382-w

Abstract

PURPOSE: Humeral head resurfacing (HHR) is a less invasive, anatomic alternative to the conventional stemmed hemiarthroplasty in patients in whom isolated humeral head replacement is preferred. It was hypothesized that, in a mid-term cross-sectional subjective outcome analysis, HHR would have equivalent patient-reported and functional outcomes to stemmed hemiarthroplasty (HA).
METHODS: A total of 213 HHR and 153 HA procedures were performed at a single academic institution from 2000 to 2014. Of these, 106 HHR and 47 HA patients corresponding with 120 HHR and 55 HA shoulders responded to a survey that collected patient demographics, surgical outcomes, patient satisfaction, and self-reported range of motion scores using both bespoke and validated metrics.
RESULTS: Follow-up was longer in the HA group (9.4 ± 3.4 vs. 5.2 ± 1.8 years, p < 0.0001). Self-reported range of motion was equivalent between groups. Surgery was perceived as helpful following 76.7% of HHRs and 78.2% of HAs (p > 0.99). The ASES pain subscore was significantly worse in the HA group (25.2 ± 29.5 vs. 38.5 ± 12.7 after HHR, p < 0.0001), which translated into worse ASES total scores (45.1 ± 14.8 HA vs. 52.2 ± 23.7 HHR, p < 0.05). These findings were equivocal in responses received 2-8 years vs. ≥ 8 years after surgery.
CONCLUSIONS: Indications should be equivocal; humeral head resurfacing is a viable alternative to hemiarthroplasty, with equivalent patient satisfaction and reduced pain in the mid-term post-operative period.
LEVEL OF EVIDENCE: III.

Keywords

Hemiarthroplasty Humeral head resurfacing Mid-term follow-up Patient-reported outcomes Rotator cuff dysfunction Shoulder arthroplasty Shoulder osteoarthritis

References

J Bone Joint Surg Am. 2000 Jan;82(1):26-34 [PMID: 10653081]
J Bone Joint Surg Br. 2001 Mar;83(2):213-21 [PMID: 11284568]
Clin Orthop Relat Res. 2005 Oct;439:101-8 [PMID: 16205147]
J Bone Joint Surg Am. 2006 Apr;88(4):900-5 [PMID: 16595483]
Am J Orthop (Belle Mead NJ). 2007 Dec;36(12 Suppl 1):4-8 [PMID: 18264550]
J Bone Joint Surg Am. 2009 May;91(5):1228-38 [PMID: 19411474]
J Shoulder Elbow Surg. 2012 Apr;21(4):554-60 [PMID: 21393018]
Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S383-412 [PMID: 22588759]
J Shoulder Elbow Surg. 2013 May;22(5):612-9 [PMID: 23149276]
J Bone Joint Surg Am. 2012 Nov 21;94(22):e164 [PMID: 23172331]
Arch Orthop Trauma Surg. 2013 May;133(5):615-9 [PMID: 23494113]
J Shoulder Elbow Surg. 2013 Oct;22(10):1352-8 [PMID: 23562291]
Semin Arthritis Rheum. 2013 Dec;43(3):297-302 [PMID: 23735559]
J Shoulder Elbow Surg. 2014 Jan;23(1):e14-22 [PMID: 23834995]
Open Orthop J. 2013 Sep 06;7:334-7 [PMID: 24082971]
J Orthop Sports Phys Ther. 2015 Jan;45(1):25-36 [PMID: 25394688]
Acta Orthop. 2015 Feb;86(1):71-7 [PMID: 25409254]
Am J Sports Med. 2015 Mar;43(3):579-87 [PMID: 25564407]
J Shoulder Elbow Surg. 2015 Jul;24(7):1049-60 [PMID: 25601383]
Orthop J Sports Med. 2014 Jan 21;2(1):2325967113519407 [PMID: 26535268]
J Shoulder Elbow Surg. 2016 May;25(5):772-80 [PMID: 26700556]
Am J Sports Med. 2016 Mar 9;44(6):1417-1422 [PMID: 26960913]
Int J Shoulder Surg. 2016 Jan-Mar;10(1):21-7 [PMID: 26980986]
Clin Orthop Relat Res. 2016 Dec;474(12):2672-2681 [PMID: 27392769]
J Shoulder Elbow Surg. 2017 Jan;26(1):144-148 [PMID: 27545048]
World J Orthop. 2016 Sep 18;7(9):519-26 [PMID: 27672564]
J Bone Joint Surg Am. 2016 Oct 5;98(19):1631-1637 [PMID: 27707849]
Clin Orthop Relat Res. 2017 Apr;475(4):933-946 [PMID: 28050812]
Acta Orthop. 2017 Jun;88(3):310-314 [PMID: 28121220]
J Am Acad Orthop Surg. 2018 Sep 1;26(17):e361-e370 [PMID: 30095514]
AJR Am J Roentgenol. 1985 May;144(5):967-72 [PMID: 3872581]
J Shoulder Elbow Surg. 1997 Sep-Oct;6(5):449-54 [PMID: 9356934]

Grants

  1. Internal Grant/Albert Ferguson Research Grant, Department off Orthopaedic Surgery, University of Pittsburgh

MeSH Term

Aged
Cross-Sectional Studies
Female
Follow-Up Studies
Hemiarthroplasty
Humans
Humeral Head
Male
Middle Aged
Osteoarthritis
Patient Satisfaction
Range of Motion, Articular
Shoulder Joint
Treatment Outcome
Comparative Study Journal Article

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