TITLE

Hemiarthroplasty for the Rotator Cuff-Deficient Shoulder

AUTHOR(S)
Goldberg, Steven S.; Bigliani, Louis U.
PUB. DATE
March 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;Mar2009 Supplement, Vol. 91-A, p22
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
BACKGROUND: Hemiarthroplasty is a common treatment for cuff tear arthropathy and glenohumeral arthritis associated with a massive tear of the rotator cuff; however, to our knowledge, long-term outcomes and preoperative factors affecting results have not been reported. METHODS: Thirty-four shoulders in thirty-one patients with cuff tear arthropathy or a massive rotator cuff tear with glenohumeral arthritis underwent hemiarthroplasty at an average age of seventy-two years. Outcomes in all patients were evaluated by direct physical examination and according to the limited goals criteria of Neer et al. at a mean of 3.7 years postoperatively. In twenty-five shoulders, long-term outcomes were measured with use of the American Shoulder and Elbow Surgeons (ASES) scoring system and follow-up data were obtained at a mean of ten years (range, four to sixteen years) postoperatively. RESULTS: Twenty-six of thirty-four shoulders satisfied the limited goals criteria described by Neer et al. The mean active forward elevation improved from 78° preoperatively to 111° postoperatively (p < 0.001). The mean active external rotation improved from 15° preoperatively to 38° postoperatively (p < 0.0001). One patient with a history of four failed rotator cuff repairs had anterosuperior instability develop after surgery. The mean final total ASES score was 67 points (range, 35 to 100 points). Of the sixteen shoulders in patients who could actively elevate the arm to ⩾90° preoperatively, fourteen achieved satisfactory results according to the limited goals criteria of Neer et al. Patients who could actively elevate the arm to 900 had significantly better function (mean ASES function score, 31 compared with 23 points; p = 0.05), pain relief (mean ASES pain score, 48 compared with 30 points; p = 0.002), and higher total ASES scores (mean, 80 compared with 54 points; p < 0.001) than the patients who were unable to actively elevate the arm to 90°. CONCLUSIONS: Hemiarthroplasty can provide good long-term results in rotator cuff-deficient patients with glenohumeral arthritis. Patients who have preoperative forward elevation of ⩾90° benefit the most. A low complication rate can be expected for this procedure. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
36977805

 

Related Articles

  • Traumatic Anterosuperior Rotator Cuff Tears: The Outcome of Open Surgical Repair. Namdari, Surena; Henn, III, R. Frank; Green, Andrew // Journal of Bone & Joint Surgery, American Volume;Sep2008, Vol. 90-A Issue 9, p1906 

    Background: Anterosuperior rotator cuff tears involving the subscapularis and supraspinatus tendons are less common than posterosuperior tears and are rarely discussed in the literature. The purpose of this study was to identify the unique features of this injury and to assess the outcome of...

  • rhBMP- 12 Accelerates Healing of Rotator Cuff Repairs in a Sheep Model. Seeherman, Howard J.; Archambault, Joanne M.; Rodeo, Scott A.; Turner, A. Simon; Zekas, Lisa; D'Augusta, Darren; Li, X. Jian; Smith, Erica; Wozney, John M. // Journal of Bone & Joint Surgery, American Volume;Oct2008, Vol. 90-A Issue 10, p2206 

    Background: The success rate of rotator cuff repairs is variable. This study was performed to evaluate the ability of recombinant human bone morphogenetic protein-12 (rhBMP-12), administered in several carriers, to accelerate healing in a sheep model of rotator cuff repair. Methods: Local...

  • The Outcome and Structural Integrity of Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor Technique. Lafosse, Laurent; Brzoska, Roman; Toussaint, Bruno; Gobezie, Reuben // Journal of Bone & Joint Surgery, American Volume;Oct2008 Supplement 2, Vol. 90-A, p275 

    BACKGROUND: The reported rate of failure after arthroscopic rotator cuff repair has varied widely. The influence of the repair technique on the failure rates and functional outcomes after open or arthroscopic rotator cuff repair remains controversial. The purpose of the present study was to...

  • Tendon Integrity and Functional Outcome After Arthroscopic Repair of High-Grade Partial-Thickness Supraspinatus Tears. Kamath, Ganesh; Galatz, Leesa M.; Keener, Jay D.; Teefey, Sharlene; Middleton, William; Yamaguchi, Ken // Journal of Bone & Joint Surgery, American Volume;May2009, Vol. 91-A Issue 5, p1055 

    Background: Partial-thickness rotator cuff tears are a common cause of shoulder pain, yet the appropriate surgical treatment is controversial. In particular, very little information is available regarding rotator cuff integrity after operative repair. The purpose of this study was to evaluate...

  • Mini-Open Rotator Cuff Repair Improved Quality of Life at 3 Months.  // Journal of Bone & Joint Surgery, American Volume;Feb2009, Vol. 91-A Issue 2, p494 

    The article reports on the results of research which was conducted in an effort to determine whether standard open acromioplasty with rotator cuff repair or arthroscopic acromioplasty with mini-open rotator cuff repair leads to a better quality of life for patients with full-thickness rotator...

  • The Use of an Intra-Articular Depth Guide in the Measurement of Partial Thickness Rotator Cuff Tears. Carroll, Michael J.; More, Kristie D.; Sohmer, Stephen; Nelson, Atiba A.; Sciore, Paul; Boorman, Richard; Hollinshead, Robert; Lo, Ian K. Y. // Advances in Orthopedics;2013, p1 

    Purpose. The purpose of this study was to compare the accuracy of the conventional method for determining the percentage of partial thickness rotator cuff tears to a method using an intra-articular depth guide. The clinical utility of the intra-articular depth guide was also examined. Methods....

  • 양측성 회전근 ê°œ 파열에 대한 수술적 치료 ê²°ì • 및 ê²°ê³¼. 장호진; 최창혁; 엄윤식 // Journal of the Korean Orthopaedic Association;Jun2013, Vol. 48 Issue 3, p213 

    Purpose: We evaluated the influencing factors in selection of initial operation and outcomes after operative treatment of symptomatic rotator cuff tear including both sides. Materials and Methods: From December 2000 to March 2011, 60 shoulders of 30 patients underwent arthroscopic rotator cuff...

  • Internal rotator and external rotator weakness associated with recurrent anterior instability. Owens, Colleen; Press, Robert // Orthopedics Today;Jun2011, Vol. 31 Issue 6, p20 

    The article focuses on a study led by P. Edouard and published in a 2011 issue of the "Journal of Bone and Joint Surgery" which found that recurrent anterior instability may lead to weakness in the internal and external rotator, with side-to-side differences depending on the side of hand dominance.

  • Shoulder Resurfacing. Burgess, Derrick L.; McGrath, Mike S.; Bonutti, Peter M.; Marker, David R.; Delanois, Ronald E.; Mont, Michael A. // Journal of Bone & Joint Surgery, American Volume;May2009, Vol. 91-A Issue 5, p1228 

    ...Resurfacing is a type of shoulder arthroplasty that involves replacing the humeral joint surface with a metal covering, or cap, thus preserving the bone of the proximal part of the humerus. If the glenoid is also replaced, a current conventional polyethylene glenoid replacement prosthesis or...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics