Shoulder arthroplasty for atraumatic osteonecrosis of the humeral head

Journal of Shoulder and Elbow Surgery
Bradley SchochJohn W Sperling

Abstract

Osteonecrosis (ON) of the humeral head represents <5% of the shoulder arthroplasty population. Depending on the stage of disease, surgeons must decide between hemiarthroplasty (HA) and total shoulder arthroplasty (TSA). To date, the peer-reviewed literature offers minimal insight into the best form of treatment of this population of patients. Between August 1973 and November 2010, 141 shoulder arthroplasties were performed for operatively confirmed ON of the humeral head; 67 HAs and 71 TSAs were observed for at least 2 years (mean, 9.3 years) or until reoperation. Indications for surgery included imaging-confirmed ON in a patient who had failed to respond to conservative treatment modalities. Shoulder arthroplasty provided significant improvements in pain scores (P < .001), elevation (P < .01), and external rotation (P < .01) for both the HA and TSA populations. Both groups showed similar patient-reported satisfaction (>75%) and excellent/satisfactory Neer ratings (>65%). Eleven percent of HAs had moderate to severe glenoid erosion at follow-up, and 25% of glenoid components were radiographically at risk. Eight HAs and 11 TSAs underwent reoperation. The most common cause for reoperation was painful glenoid arthrosis in the HA g...Continue Reading

References

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Citations

Nov 22, 2015·Journal of Shoulder and Elbow Surgery·Bradley S SchochJohn W Sperling
Apr 26, 2019·The Journal of Orthopaedic and Sports Physical Therapy·Garrett S BullockJune Kennedy
May 27, 2020·Archives of Orthopaedic and Trauma Surgery·Ruben DukanPatrick Boyer
Feb 26, 2021·Revista Brasileira De Ortopedia·Alberto Naoki MiyazakiFelipe Cerávolo Lemos
Mar 25, 2021·Morphologie : Bulletin De L'Association Des Anatomistes·P Le CozH Thomazeau
Mar 24, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Stefanos TsitlakidisBoris Sowa

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