Hemiarthroplasty for osteoarthritis in shoulder with dysplastic morphology

Abstract

Hypothesis: Hemiarthroplasty for shoulder osteoarthritis with a glenoid dysplasia gives satisfactory results at medium-range follow-up.

Materials and methods: From 1998 to 2006, 9 patients (10 shoulders) with glenoid dysplasia and osteoarthritis were treated with shoulder hemiarthroplasty. The mean age at surgery was 54 years (range, 44-73 years). At a minimum of 24 months after surgery, all patients were retrospectively reviewed with a clinical and radiographic evaluation. The average duration of follow-up was 71 months (range, 28-126 months).

Results: One shoulder underwent revision surgery for anterior dislocation within 6 months after the initial procedure. The pain level improved significantly, with no or slight pain for 9 of the 10 shoulders. Postoperatively active external rotation and anterior elevation increased significantly, with a mean of 34.5° and 124°, respectively. The average American Shoulder and Elbow Surgeons score was 81.5 points at the last follow-up, and results were considered as excellent or satisfactory in 7 shoulders according to the modified Neer rating scale. Erosion of the glenoid was considered as slight on radiographs, and radiolucencies were seen around humeral stem in one case.

Discussion: The opportunity of glenoid component implantation in case of anatomic shoulder replacement with dysplastic morphology has to be carefully evaluate because of bone stock insufficiency, glenoid orientation, and the age of patients.

Conclusions: Despite a limited number of patients in this study, hemiarthroplasty gave satisfactory clinical results in most cases. It seems to be a reliable option to treat osteoarthritis in case of dysplastic morphology of shoulder.