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Intraoperative photo showing the resurfaced humeral head.
Courtesy of Anand M. Murthi, MD

AAOS Now

Published 6/1/2008
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Peter Pollack

Shoulder resurfacing benefits younger patients

Shoulder resurfacing arthroplasty may be a viable alternative to standard stemmed implants in younger patients, according to the results of a case-controlled study presented by Anand M. Murthi, MD, at the 6th Biennial AAOS/American Shoulder and Elbow (ASES) Meeting.

Dr. Murthi along with Bryan Butler, MD, prospectively followed 17 patients (16 men, 1 woman) who underwent shoulder resurfacing arthroplasty. Patients ranged in age from 19 years to 40 years old (mean: 35 years). Patients were evaluated for pain and range of motion scores both before and after the resurfacing procedure. All patients answered the Simple Shoulder Test (SST) and the ASES questionnaires.

Before surgery, the average pain score was 7.3 on a scale of 10 (most painful). Patients had an average forward elevation of 110 degrees, external rotation of 20.8 degrees, and internal rotation to L1. The average SST score was 3.6, and the average ASES score was 38.3.

Eight patients were diagnosed with osteoarthritis, 7 with osteonecrosis, and 2 with chronic anterior dislocation. A single surgeon performed all of the surgeries.

Radiographs were taken at the 1-month, 3-month, 6-month, and 1-year follow-up visits; final follow-up took place from 24 months to 62 months after surgery (mean 40 months).

At final follow-up, average pain values had decreased to 1.8 on the 10 point scale. The average range of motion had improved to 152.1 degrees forward elevation (p<0.005), 55.3 degrees external rotation, and internal rotation to t10 (>p<0.005). the ases scores improved to 80.4 (>p<0.005), and the average sst scores improved to 10.1 (>p<0.005).>

Radiographs taken at the final follow-up revealed no interval change in component position, and no incidences of symptomatic component loosening or failure were found. Contained, nonprogressive osteolysis developed in one patient. Complications from the surgery included one wound infection, which was treated successfully with irrigation, d├ębridement, and antibiotics. Of 10 patients who participated in recreational sports, 8 had returned to their previous level of sports activity at the time of the final follow-up.

Dr. Murthi stated that the study results indicate that shoulder resurfacing arthroplasty can provide a successful alternative to standard stemmed implants in a young patient population.

Disclosure information on the authors can be found at www.aaos.org/disclosure

Peter Pollack is a staff writer for AAOS Now. He can be contacted at ppollack@aaos.org