Shoulder resurfacing for treatment of focal defects and diffuse osteoarthritis

Resurfacing der Schulter zur Behandlung von fokalen Defekten und diffuser Arthrose

Abstract

This article provides a review of the various options for the treatment of osteoarticular pathology of the shoulder. This can range from focal osteochondral defects to diffuse arthritis and can occur at any age. Although total shoulder arthroplasty and hemiarthroplasty are the most frequently used methods, they not generally suitable for younger patients under 60 years old due to the lack of long-term stability and deterioration. If conservative treatment is unsuccessful or not an option, resurfacing is an alternative procedure with good long-term results. The various methods that have been reported for resurfacing and partial resurfacing of the humeral head are described as well as the results of studies on these procedures. In this article the indications, biomechanics, outcomes and complications are outlined for the two resurfacing options preferred by the authors.

Zusammenfassung

Dieser Beitrag gibt einen Überblick über die verschiedenen Optionen zur Behandlung der osteoartikulären Pathologie der Schulter. Diese kann von fokalen osteochondralen Defekten bis hin zu diffuser Arthrose reichen und in jedem Alter auftreten. Obwohl die Schultertotalendoprothese und die Hemiarthroplastik die am häufigsten verwendeten Methoden sind, eignen sie sich aufgrund der fehlenden Langzeitstabilität und der Verschlechterung im Allgemeinen nicht für jüngere Patienten unter 60 Jahren. Wenn eine konservative Behandlung nicht erfolgreich ist oder keine Option darstellt, ist das Resurfacing ein alternatives Verfahren mit guten Langzeitergebnissen. Es werden sowohl die verschiedenen Methoden für das Resurfacing bzw. das partielle Resurfacing des Humeruskopfes beschrieben als auch die Ergebnisse von Studien zu diesen Verfahren. In diesem Artikel werden Indikationen, Biomechanik, Ergebnisse und Komplikationen der beiden von den Autoren bevorzugten Resurfacing-Varianten beschrieben.

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Abbreviations

ASES:

American shoulder and elbow surgeons

AVN:

Avascular necrosis

HA:

Hemiarthroplasty

HHR:

Humeral head resurfacing

HR:

Hazard ratio

HSL:

Hill-Sachs lesion

MCID:

Minimum clinically important difference

PGBG:

Posterior glenoid bone grafting

PSS:

Penn shoulder score

ROM:

Range of motion

SANE:

Single Assessment Numeric Evaluation shoulder patient reported outcome measure

SF-12:

Short Form survey, patient reported mesure to assess impact of health on everyday life

SST:

Simple shoulder test

TSA:

Total shoulder arthroplasty

VSA:

Visual analog scale

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Correspondence to Dr. A. Miniaci.

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Conflict of interest

A. Miniaci received consulting fees and royalties from Arthrosurface related to intellectual property related to the subject of this work. M. J. Scarcella declare that he (or she) has no competing interests. Neither of the authors, their immediate families nor any research foundation with which they are affiliated have received any financial payments or other benefits from any commercial entity related to the subject of this article.

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For this article no studies with human participants or animals were performed by any of the authors. There were clinical studies referenced that were performed in accordance with the ethical standards indicated in each case.

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Miniaci, A., Scarcella, M.J. Shoulder resurfacing for treatment of focal defects and diffuse osteoarthritis. Orthopäde 50, 112–118 (2021). https://doi.org/10.1007/s00132-020-04055-8

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Keywords

  • Total shoulder arthroplasty
  • Hemiarthroplasty
  • Humeral head
  • Nonspherical anatomic humeral head
  • Resurfacing

Schlüsselwörter

  • Schultertotalendoprothese
  • Hemiarthroplastik
  • Humeruskopf
  • Nicht sphärischer anatomischer Humeruskopf
  • Resurfacing