Partial humeral head resurfacing for osteonecrosis

• Published in: Journal of shoulder and elbow surgery 2009-09, Vol.18 (5), p.711-716
• Main Authors: Uribe, John W., MD, Botto-van Bemden, Angie, PhD
• Format: Article
• Language: English
• Subjects: Aged; Arthroplasty, Replacement - methods; Biological and medical sciences; Cohort Studies; constant score; Diseases of the osteoarticular system; Female; Follow-Up Studies; Humans; humeral head; humeral head resurfacing; Humerus - diagnostic imaging; Humerus - pathology; Humerus - surgery; Male; Medical sciences; Middle Aged; Orthopedics; Osteonecrosis; Osteonecrosis - diagnostic imaging; Osteonecrosis - surgery; Pain Measurement; Postoperative Complications; Prospective Studies; Prosthesis Design; Prosthesis Fitting; Range of Motion, Articular; Recovery of Function; Risk Assessment; Severity of Illness Index; Shoulder Joint - diagnostic imaging; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Shoulder Pain - diagnosis; Shoulder Pain - surgery; shoulder score index; Tomography, X-Ray Computed; Treatment Outcome; Vascular bone diseases; WOSI score
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2008.10.016

Background The purpose of this study is to present our experience treating patients in the advanced stages of osteonecrosis of the humeral head with partial resurfacing of the humeral head. Methods This is a prospective series of 12 shoulders in 11 patients diagnosed with osteonecrosis of the humeral head who underwent partial humeral head resurfacing. Their mean age was 56 years. Preoperative and postoperative standardized evaluations included history, physical examination, radiographs, and clinical scoring systems, including the Western Ontario Osteoarthritis of the Shoulder index, Shoulder Score Index derived from the American Shoulder and Elbow Surgeons evaluation form, Constant score, and score on the visual analog scale for pain. The mean follow-up was 30 months. Results Postoperatively, all patients reported significant pain relief. Scores on the visual analog scale for pain improved from 75 preoperatively to 16 postoperatively (P < .001). Physical examination showed significant improvements in functional outcomes as well. Forward elevation improved from a mean of 94° preoperatively to 142° postoperatively (P < .001). Good to excellent results were also observed for the Western Ontario Osteoarthritis of the Shoulder index, Shoulder Score Index, and Constant score. Conclusions This prospective series on partial resurfacing of the humeral head for patients with advanced-stage osteonecrosis has shown it to be effective in relieving pain and restoring function. Level of evidence Level 2; Prospective cohort treatment study.