Cementless surface replacement arthroplasty of the shoulder

Outcome of Copeland surface replacement shoulder arthroplasty

“…This compares favorably with series of stemmed implants that report a similarly low rate of fracture but an operative intervention rate of 55% to 72%. 2,18 Our global results are similar to those of Levy and Copeland 10 (Figure 3), but their series had a different case mix. The subgroup comparisons for operation type (hemiarthroplasty) and preoperative diagnosis (rheumatoid arthritis or osteoarthritis) show small differences, which reflect the preoperative scores.…”

“…4,10 In particular, in this series, some of the rheumatoid patients underwent ipsilateral stemmed elbow replacement without the vacant segment effect described by Gill et al 6,8 None of our ipsilateral shoulder and stemmed elbow arthroplasty patients has had fracture between the 2 implants. The single case of periprosthetic fracture in this series involved the humeral neck and was managed nonoperatively.…”

“…This rate of reoperation may reflect a situation in which improved postoperative flexion and abduction unmask impingement. The Neviaser anterosuperior approach is advocated by Levy and Copeland 10 to facilitate subacromial decompression, if indicated. 13 We now have a low threshold for performing this at the start of the procedure, and a case could be made for it to be done routinely.…”

“…It is otherwise the same as that used in the series of Levy and Copeland. 10 This is the first report of outcomes with this prosthesis outside the center in which it was developed.…”

“…This confers theoretical advantages including preservation of bone stock and the ability to mimic normal joint geometry, 1,7 which a stemmed prosthesis may not achieve. 14,15 The only published series to date, that of Levy and Copeland, 10 reports results for 103 patients comparable in terms of pain relief and movement to those obtained with stemmed implants.…”