Clinical and Radiographic Outcomes of Shoulder Hemiarthroplasty for Patients with Glenoid Medialization

Benjamin R Campbell; Corey Schiffman; Raymond Chen; Justin Wong; John G Horneff; Mark Lazarus

doi:10.1016/j.jse.2024.03.010

Clinical and Radiographic Outcomes of Shoulder Hemiarthroplasty for Patients with Glenoid Medialization

J Shoulder Elbow Surg. 2024 Apr 15:S1058-2746(24)00257-X. doi: 10.1016/j.jse.2024.03.010. Online ahead of print.

Authors

Benjamin R Campbell¹, Corey Schiffman², Raymond Chen³, Justin Wong⁴, John G Horneff⁵, Mark Lazarus⁶

Affiliations

¹ Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Benjamin.campbell@rothmanortho.com.
² Department of Orthopaedic Surgery and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA.
³ Department of Orthopaedic Surgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
⁴ OrthoArizona, Phoenix, AZ, USA.
⁵ Department of Orthopaedics, University of Pennsylvania, Philadelphia, PA, USA.
⁶ Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.

PMID: 38631455
DOI: 10.1016/j.jse.2024.03.010

Abstract

Background: Glenoid bone loss in shoulder arthroplasty is a difficult problem that is prone to complications due to challenges with achieving glenoid component fixation and stability. The purpose of this study was to evaluate the outcomes of primary shoulder hemiarthroplasty for patients with severe glenoid medialization precluding placement of a glenoid component.

Methods: This was a retrospective case series evaluating patients who underwent shoulder hemiarthroplasty for severe glenoid erosion and medialization between 2010 and 2020. Patients were evaluated via chart review and phone survey to determine if there were any reoperations at final follow-up and to obtain Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) scores. Preoperative and postoperative radiographs were evaluated and compared to determine glenoid morphology, version, medialization, acromiohumeral distance, and humeral offset. Final postoperative films were also evaluated for anterosuperior migration and signs of mechanical failure including loosening or periprosthetic fracture.

Results: Overall, there were 28 patients during this period who underwent shoulder hemiarthroplasty for severe glenoid medialization. Eight patients were deceased at the time of the study, 2 were unable to complete surveys due to dementia, and 7 were lost to follow-up. The final cohort included 11 shoulders and 11 patients with mean age of 71 +/- 7.1 years and mean follow-up of 6.7 years (range 1.6 - 13.0 years). Mean postoperative SANE, ASES, and SST scores were 80.6 +/- 17.6, 71.5 +/- 29.3, and 7.6 +/- 2.0, respectively. There were no reoperations or revision surgeries at final follow-up. Radiographic evaluation demonstrated severe glenoid medialization and decreased lateral humeral offset which was unchanged postoperatively. There were 2 patients with signs of anterosuperior migration at final radiographic follow-up but no signs of implant failure.

Conclusion: Shoulder hemiarthroplasty for severe medial glenoid bone loss provides modest clinical outcomes and low rates of reoperation at mid to long term follow-up and is an option worth considering in cases where placement of a glenoid component is challenging due to deficient bone stock and high risk for complications.

Keywords: bone loss; glenoid; medial erosion; patient outcomes; shoulder hemiarthroplasty.