Institutional members access full text with Ovid®

Share this article on:

Outcome of Revision Shoulder Arthroplasty After Resurfacing Hemiarthroplasty in Patients with Glenohumeral Osteoarthritis

Rasmussen, Jeppe V. MD, PhD; Olsen, Bo S. MD, PhD; Al-Hamdani, Ali MD; Brorson, Stig MD, PhD, DMSc

Journal of Bone & Joint Surgery - American Volume: 5 October 2016 - Volume 98 - Issue 19 - p 1631–1637
doi: 10.2106/JBJS.15.00934
Scientific Articles

Background: Patients are often treated with a resurfacing hemiarthroplasty in the expectation that the bone-preserving design facilitates revision should the need for a revision arthroplasty arise. The aim of this study was to report the outcome of patients with glenohumeral osteoarthritis who underwent revision shoulder arthroplasty after resurfacing hemiarthroplasty.

Methods: We reviewed all patients with osteoarthritis reported to the Danish Shoulder Arthroplasty Registry from 2006 to 2013. There were 1,210 primary resurfacing hemiarthroplasties, of which 107 cases (9%) required a revision surgical procedure, defined as the removal or exchange of the humeral component or the addition of a glenoid component. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index was used to evaluate outcome at 1 year.

Results: The median WOOS of revision arthroplasty after failed resurfacing hemiarthroplasty was 62 points (interquartile range, 40 to 88 points). Of the 80 cases that had follow-up, 33 (41%) had an unacceptable outcome, defined as a WOOS of ≤50 points. Of the 107 cases that required a revision surgical procedure, 11 arthroplasties (10%) required a further revision surgical procedure. The resurfacing hemiarthroplasty was revised to a stemmed hemiarthroplasty (n = 39), anatomic total shoulder arthroplasty (n = 31), or reverse shoulder arthroplasty (n = 30). In 7 cases, the revision arthroplasty design was unknown. The median WOOS of patients who underwent revision stemmed hemiarthroplasty (48 points) was significantly inferior (p = 0.002) to that of patients who underwent primary stemmed hemiarthroplasty (75 points); the median WOOS of patients who underwent revision anatomic total shoulder arthroplasty (74 points) was also significantly inferior (p = 0.007) to that of patients who underwent primary anatomic total shoulder arthroplasty (93 points). However, the median WOOS of patients who underwent revision reverse shoulder arthroplasty (68 points) was not significantly different (p = 0.66) from that of patients who underwent primary reverse shoulder arthroplasty (77 points) used in the treatment of osteoarthritis.

Conclusions: The outcome of revision shoulder arthroplasty after failed resurfacing hemiarthroplasty was variable and, in many cases, disappointing. It is important that resurfacing hemiarthroplasty is used for the correct indications and with adequate technique and skill. When resurfacing hemiarthroplasty is used in the treatment of osteoarthritis, revision cannot be counted upon as a fallback.

Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

1Department of Orthopaedic Surgery, Herlev University Hospital, Herlev, Denmark

E-mail address for J.V. Rasmussen: jevera01@heh.regionh.dk

Copyright 2016 by The Journal of Bone and Joint Surgery, Incorporated
You currently do not have access to this article

To access this article: