Cementless surface replacement hemiarthroplasty for primary glenohumeral osteoarthritis: results of over 5-year follow-up in patients with or without rotator cuff deficiency

Al-Hadithy, Nawfal; Furness, N; Jonas, Sam C.; Jobbagy, Attila; Lowdon, I.M.R.; Woods, David

doi:10.1177/1758573215573456

Cited by 8 publications

(11 citation statements)

References 30 publications

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“…Outcome scores for OA were lower than those from another study of CRHA for OA in 2012 which found postoperative OSS of 42 (versus 35 in this study) and Constant score of 62.5 (versus 49.9 in this study), although this was a small single surgeon series. 18 Functional outcomes for HA have not been proven superior to resurfacing with a recent study publishing a 5-year mean OSS of 32.7 19 although the Oxford group found the minimum 3-year (53.5 months mean follow-up) OSS of 38.8 for HA in OA with an intact rotator cuff. 20 A Danish randomized trial found similar CMS in OA patients treated with resurfacing hemiarthroplasty (48.9) to this study (49.9) although this was not using the CRHA prosthesis.…”

Section: Discussionmentioning

confidence: 99%

6-Year clinical results and survival of Copeland Resurfacing hemiarthroplasty of the shoulder in a consecutive series of 279 cases

Dekker

Joshi

Morgan

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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Background: Medium-term clinical results and survival of the Copeland resurfacing hemiarthroplasty of the shoulder (CRHA) in a large consecutive group are presented with a comparison of outcomes for underlying pathologies. Methods: A consecutive series of patients undergoing CRHA over 14 years was retrospectively analysed with no exclusions. Patients had a minimum 2-year follow-up by an independent assessor. Functional outcome was assessed using the Oxford Shoulder Score (OSS) and Constant-Murley Score (CMS). Pain and satisfaction was assessed using a visual analogue score. Results: 279 CRHAs were performed in 242 patients between 2002 and 2016. The mean follow-up was 6 years. The indication for surgery was osteoarthritis (OA) in 212, inflammatory arthropathy (RA) in 35, rotator cuff tear arthropathy (CTA) in 22 and avascular necrosis (AVN) in 2. For the OA group, 5-year survival was 90%, 10-year survival was 83% and mean survival was 13.2 years (95% CI 12.5e13.9). The mean OSS was 35.0 and mean CMS 49.9. CRHA for CTA had significantly poorer (p < 0.001) 5-year survival (55%), 10-year survival (41%) and mean survival (5.9 years, 95% CI 4.7e7.2). Mean OSS was 23.6 and mean CMS 30.3, which was poorer than for OA (p < 0.001). A subgroup analysis of OA patients found significantly better survival (p ¼ 0.013) in those aged over 65 years but no difference in functional outcome. Conclusion: CRHA remains a reasonable option for OA in patients with an intact rotator cuff and with sufficient bone stock, especially in those aged over 65 years. With poorer functional outcomes and survival, CRHA should not be offered in those with CTA.

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Section: Discussionmentioning

confidence: 99%

6-Year clinical results and survival of Copeland Resurfacing hemiarthroplasty of the shoulder in a consecutive series of 279 cases

Dekker

Joshi

Morgan

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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“…Especially, RHA has been promoted as a bone-sparing alternative to SHA for over ten years among doctors and patients. Various types of resurfacing procedures have been described in terms of shortand mid-term clinical effectiveness by mounting studies [32,53,[57][58][59][60] and a recent systemic review [61] suggested that resurfacing replacements could provide a significant improvement in pain, motion, and standardized outcome scores.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it can also provide pain relief and avoid the glenoid loosening associated with TSA [ 22 ]. With continuous development and modification, HA has been applied for the treatment of various shoulder disorders, including the primary osteoarthritis (POA) [ 53 ], avascular necrosis (AVN) [ 16 ], rheumatoid arthritis (RA) [ 54 ], cuff-tear arthropathy (CTA) [ 18 ], juvenile idiopathic arthritis (JIA) [ 55 ] and post-traumatic degenerative joint disease (DJD) [ 56 ]. Especially, RHA has been promoted as a bone-sparing alternative to SHA for over ten years among doctors and patients.…”

Section: Discussionmentioning

confidence: 99%

Resurfacing hemiarthroplasty versus stemmed hemiarthroplasty for glenohumeral osteoarthritis: a meta-analysis

et al. 2020

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Background: Though total shoulder arthroplasty (TSA) has been an acknowledged treatment option for glenohumeral osteoarthritis, resurfacing hemiarthroplasty (RHA) and stemmed hemiarthroplasty (SHA) may be preferred in some circumstances by surgeons, especially for treating young or active patients. However, decision-making between the RHA and SHA is controversial. Therefore, we conducted a meta-analysis to systematically compare two surgical procedures in terms of postoperative functional outcomes, range of motion (ROM), pain relief, complication rates, risk of revision. Methods: The PubMed, Embase, Web of Science and Cochrane Library were searched from inception to January 1, 2020, for all articles that compared the clinical effectiveness and safety of RHA with SHA. All eligible studies were selected based on certain screening criteria. Two investigators independently conducted the quality assessment and extracted the data. Fixed-effect and random-effect models were used for pooled results according to the degree of heterogeneity. All statistical analyses were performed by employing Stata software 14.0. Results: A total of six comparative studies involving 2568 shoulders (1356 RHA and 1212 SHA) were included in the final analysis. Patients were followed up for at least 1 year in each study. Pooled results showed that RHA was associated with a better visual analog scale (SMD 0.61, p = 0.001) but higher revision rates (OR 1.50, p = 0.016) when compared to SHA. There were no significant differences in functional outcomes, such as Constant-Murley score (SMD 0.06, P = 0.878), American Shoulder and Elbow Surgeons score (SMD 0.05, P = 0.880), Western Ontario Osteoarthritis of the Shoulder index (SMD 0.43, p = 0.258) and quick-Disabilities of the Arm, Shoulder and Hand score (SMD 0.06, p = 0.669). In addition, no differences were observed in forward flexion (SMD 0.16, p = 0.622), external rotation (SMD-0.17, P = 0.741) and overall complication rates (OR 1.42, p = 0.198).

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“… 21 Although HHR has been thought to preserve bone stock, permitting a later revision if needed, a loss of bone volume was noted below the HHR implant, 22 and revisions after HHR had lower Western Ontario Osteoarthritis of the Shoulder Index scores. 23 It has been proposed that HHR results in poor postoperative range of motion in those with preexisting rotator cuff injury, 24 although various studies have shown that pain relief, 20 functional improvement, patient satisfaction, 25 and improved range of motion were noted postoperatively. 20 , 26 A major limitation of current HHR literature is small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Comorbidities and Postoperative Complications Do Not Influence Patient-Reported Satisfaction Following Humeral Head Resurfacing: Mid- to Long-term Follow-up of 106 Patients

Beck

Lee

Fourman

et al. 2019

Journal of Shoulder and Elbow Arthroplasty

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Background: Humeral head resurfacing (HHR) has emerged as an alternative treatment for glenohumeral osteoarthritis. We investigated the outcomes of HHR using validated patient-reported outcome (PRO) measures. Methods: A retrospective review was performed on 213 patients who underwent HHR. A PRO follow-up was performed by administering a questionnaire including the American Shoulder and Elbow Society (ASES) score, Brophy activity survey, short form of the Disabilities of the Arm, Shoulder and Hand (quickDASH) survey, and general shoulder function. PRO scores were stratified by comorbidities and complications. Results: Survey responses were received from 106 patients (51%), with a mean follow-up of 5.6 AE 1.8 years (range: 9 months to 6.1 years). Preoperative comorbidities were associated with significantly higher quickDASH scores. Postoperative complications were associated with significantly higher rates of current pain, higher visual analog scale scores, night pain, lower subjective shoulder values, and lower ASES pain and total scores. No differences in patient satisfaction were identified between the cohorts with and without preoperative comorbidities and between the cohorts with and without postoperative complications. Conclusion: In our cross-sectional analysis of mid-to long-term outcomes following HHR, preoperative comorbidities, or postoperative complications had no impact on patient-perceived postoperative satisfaction or most PROs. HHR is clinically viable in a wide variety of patients. Future work is necessary to compare the efficacy of HHR compared with more traditional total shoulder arthroplasty and stemmed hemiarthroplasty regarding long-term outcomes and appropriate indications.

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Cementless surface replacement hemiarthroplasty for primary glenohumeral osteoarthritis: results of over 5-year follow-up in patients with or without rotator cuff deficiency

Cited by 8 publications

References 30 publications

6-Year clinical results and survival of Copeland Resurfacing hemiarthroplasty of the shoulder in a consecutive series of 279 cases

6-Year clinical results and survival of Copeland Resurfacing hemiarthroplasty of the shoulder in a consecutive series of 279 cases

Resurfacing hemiarthroplasty versus stemmed hemiarthroplasty for glenohumeral osteoarthritis: a meta-analysis

Preoperative Comorbidities and Postoperative Complications Do Not Influence Patient-Reported Satisfaction Following Humeral Head Resurfacing: Mid- to Long-term Follow-up of 106 Patients

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