Humeral head resurfacing is associated with less pain and clinically equivalent functional outcomes compared with stemmed hemiarthroplasty at mid-term follow-up
- 110 Downloads
Humeral head resurfacing (HHR) is a less invasive, anatomic alternative to the conventional stemmed hemiarthroplasty in patients in whom isolated humeral head replacement is preferred. It was hypothesized that, in a mid-term cross-sectional subjective outcome analysis, HHR would have equivalent patient-reported and functional outcomes to stemmed hemiarthroplasty (HA).
A total of 213 HHR and 153 HA procedures were performed at a single academic institution from 2000 to 2014. Of these, 106 HHR and 47 HA patients corresponding with 120 HHR and 55 HA shoulders responded to a survey that collected patient demographics, surgical outcomes, patient satisfaction, and self-reported range of motion scores using both bespoke and validated metrics.
Follow-up was longer in the HA group (9.4 ± 3.4 vs. 5.2 ± 1.8 years, p < 0.0001). Self-reported range of motion was equivalent between groups. Surgery was perceived as helpful following 76.7% of HHRs and 78.2% of HAs (p > 0.99). The ASES pain subscore was significantly worse in the HA group (25.2 ± 29.5 vs. 38.5 ± 12.7 after HHR, p < 0.0001), which translated into worse ASES total scores (45.1 ± 14.8 HA vs. 52.2 ± 23.7 HHR, p < 0.05). These findings were equivocal in responses received 2–8 years vs. ≥ 8 years after surgery.
Indications should be equivocal; humeral head resurfacing is a viable alternative to hemiarthroplasty, with equivalent patient satisfaction and reduced pain in the mid-term post-operative period.
Level of evidence
KeywordsHumeral head resurfacing Hemiarthroplasty Shoulder osteoarthritis Patient-reported outcomes Rotator cuff dysfunction Shoulder arthroplasty Mid-term follow-up
This study was awarded an Albert Ferguson Research Grant, internal funding assigned by the Department of Orthopaedic Surgery at the University of Pittsburgh Medical Center.
Compliance with ethical standards
Conflict of interest
Albert Lin is a consultant for Tornier and Arthrex for work unrelated to this study.
University of Pittsburgh, IRB# PRO14090251 and PRO14110352.
- 5.Busija L, Pausenberger E, Haines TP, Haymes S, Buchbinder R, Osborne RH (2011) Adult measures of general health and health-related quality of life: medical outcomes study short form 36-item (SF-36) and short form 12-item (SF-12) health surveys, Nottingham Health profile (NHP), sickness impact profile (SIP), medical outcomes study short form 6D (SF-6D), Health Utilities Index Mark 3 (HUI3), Quality of Well-Being Scale (QWB), and Assessment of Quality of Life (AQoL). Arthritis Care Res (Hoboken) 63(11):S383–S412CrossRefGoogle Scholar
- 9.Eichinger JK, Miller LR, Hartshorn T, Li X, Warner JJ, Higgins LD (2016) Evaluation of satisfaction and durability after hemiarthroplasty and total shoulder arthroplasty in a cohort of patients aged 50 years or younger: an analysis of discordance of patient satisfaction and implant survival. J Shoulder Elbow Surg 25:772–780CrossRefPubMedGoogle Scholar
- 14.Jensen KL (2007) Humeral resurfacing arthroplasty: rationale, indications, technique, and results. Am J Orthop (Belle Mead NJ) 36:4–8Google Scholar
- 30.Tashjian RZ, Hung M, Keener JD, Bowen RC, McAllister J, Chen W et al (2017) Determining the minimal clinically important difference for the American Shoulder and Elbow Surgeons score, simple shoulder test, and visual analog scale (VAS) measuring pain after shoulder arthroplasty. J Shoulder Elbow Surg 26:144–148CrossRefPubMedGoogle Scholar