Published online Jun 18, 2021. doi: 10.5312/wjo.v12.i6.403
Peer-review started: January 27, 2021
First decision: March 8, 2021
Revised: March 15, 2021
Accepted: May 22, 2021
Article in press: May 22, 2021
Published online: June 18, 2021
Glenohumeral osteoarthritis and avascular necrosis are causes of shoulder pain and disability. Shoulder arthroplasty is the most effective treatment. The implant design has evolved during time transitioning to shorter humeral stem lengths or even stemless components.
The rationale to implant a cementless humeral head resurfacing (HHR) is to restore the patient’s individual humeral head anatomy, characterized by articular retroversion, neck shaft angle, lateral offset, and center of rotation, and it is easier to remove, preserving the bone stock for a possible future revision. The reported revision rate at a mid-term follow-up is not so high, so this could be an alternative to a total shoulder arthroplasty.
Our aim is to evaluate the medium-term outcome and survival of a cementless HHR in a group of patients affected with osteoarthritis or avascular necrosis.
This is a report of prospectively collected data using HHR in 23 patients (15 female and 8 male) after a 7.4 year follow-up.
The global revision rate was 16%. Data on 4 shoulders in 4 patients were lost because of prosthesis failure. Nineteen patients (21 shoulders) completed the follow-up. No signs of loosening were registered, while in 12 cases a glenoid erosion was found. The osteophytes appeared 7 times on the humeral side and 12 on the glenoid. Superior humeral migration was recorded in only one case.
The use of a cementless HHR in the treatment of osteoarthritis and early stage avascular necrosis could nowadays be consider a valid therapeutic option.
Further research based on well-designed studies with longer follow-up examination and with a bigger patient population need to be performed in order to elucidate the efficacy of cementless HHR.