Archives of Orthopaedic and Trauma Surgery

, Volume 137, Issue 6, pp 771–778 | Cite as

Outcome and revision rate of uncemented glenohumeral resurfacing (C.A.P.) after 5–8 years

  • P. C. GeervlietEmail author
  • M. P. J. van den Bekerom
  • P. Spruyt
  • M. Curvers
  • A. van Noort
  • C. P. J. Visser
Orthopaedic Surgery



Resurfacing of the glenohumeral joint for patients with glenohumeral arthritis has gained popularity since the first introduction. We report the mid-term results of the Global C.A.P. uncemented resurfacing shoulder prosthesis (DePuy Synthes).


From January 2007 to December 2009, 48 humeral cementless resurfacing prostheses in 46 patients were performed. All patients were diagnosed with primary glenohumeral osteoarthritis. Patients were contacted for review; the Constant Score, visual analog pain scale, Dutch Simple Shoulder Test, SF-12 scores and physical examination were assessed both preoperatively and yearly postoperatively. Complications and revision surgery were documented. Radiographs were evaluated for component size, offset, inclination, height, loosening and subluxation.


Forty-six patients (12 males) with a mean age of 72 years old (range 59–89) were included. At a mean 6.4-year follow-up (range 5–8), the Constant Score, visual analog pain scale and the Dutch Simple Shoulder Test scores improved significantly (p < 0.05) from baseline. Three patients were lost to follow-up. One patient died and two patients were not able to attend the follow-up appointments, due to other health-related issues. Eleven patients (23%) had a revision operation.


The most important findings of this study of the Global C.A.P. shoulder resurfacing arthroplasty were an increase of range of motion, a reduction of pain complaints, but a concerning high rate of revision after mid-term follow-up.

Level of evidence

Therapeutic Level IV.


Shoulder Osteoarthritis Cementless Resurfacing Arthroplasty Humerus Glenoid 


Compliance with ethical standards

Conflict of interest

The original CAP study was funded by a grant (Spaarne Gasthuis #116347 and Alrijne Hospital #221090) from DePuy/Synthes, Warsaw, IN, USA, which participated in the study design and data management. The implant used in this study was not provided free of charge. The study sponsors had no role in the in the collection, analysis, interpretation of data, in the writing of the manuscript, and in the decision to submit the manuscript for publication.

Financial remuneration

Pieter Geervliet: The author, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Michel van den Bekerom: The author, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Paul Spruyt: The author, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Maud Curvers: The author, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Arthur van Noort: Dr Van Noort is a key opinion leader for Johnson and Johnson. Cornelis Visser: Dr Visser is a key opinion leader for Johnson and Johnson.


  1. 1.
    Merolla G, Bianchi P, Lollino N, Rossi R, Paladini P, Porcellini G (2013) Clinical and radiographic mid-term outcomes after shoulder resurfacing in patients aged 50 years old or younger. Musculoskelet Surg 97(Suppl 1):23–29. doi: 10.1007/s12306-013-0261-4 CrossRefPubMedGoogle Scholar
  2. 2.
    Cuomo F, Birdzell MG, Zuckerman JD (2005) The effect of degenerative arthritis and prosthetic arthroplasty on shoulder proprioception. J Shoulder Elb Surg 14(4):345–348. doi: 10.1016/j.jse.2004.07.009 CrossRefGoogle Scholar
  3. 3.
    van den Bekerom MP, Geervliet PC, Somford MP, van den Borne MP, Boer R (2013) Total shoulder arthroplasty versus hemiarthroplasty for glenohumeral arthritis: a systematic review of the literature at long-term follow-up. Int J Shoulder Surg 7(3):110–115. doi: 10.4103/0973-6042.118915 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Lebon J, Delclaux S, Bonnevialle N, Rongieres M, Bonnevialle P, Mansat P (2014) Stemmed hemiarthroplasty versus resurfacing in primary shoulder osteoarthritis: a single-center retrospective series of 78 patients. Orthop Traumatol Surg Res 100(6 Suppl):S327–S332. doi: 10.1016/j.otsr.2014.05.012 CrossRefPubMedGoogle Scholar
  5. 5.
    Schmidutz F, Sprecher CM, Milz S, Gohlke F, Hertel R, Braunstein V (2015) Resurfacing of the humeral head: an analysis of the bone stock and osseous integration under the implant. J Orthop Res 33(9):1382–1390. doi: 10.1002/jor.22902 CrossRefPubMedGoogle Scholar
  6. 6.
    Torchia ME, Cofield RH, Settergren CR (1997) Total shoulder arthroplasty with the Neer prosthesis: long-term results. J Shoulder Elb Surg 6(6):495–505CrossRefGoogle Scholar
  7. 7.
    Hawkins RJ, Greis PE, Bonutti PM (1999) Treatment of symptomatic glenoid loosening following unconstrained shoulder arthroplasty. Orthopedics 22(2):229–234PubMedGoogle Scholar
  8. 8.
    Hasan SS, Leith JM, Campbell B, Kapil R, Smith KL, Matsen FA III (2002) Characteristics of unsatisfactory shoulder arthroplasties. J Shoulder Elb Surg 11(5):431–441CrossRefGoogle Scholar
  9. 9.
    Bohsali KI, Wirth MA, Rockwood CA Jr (2006) Complications of total shoulder arthroplasty. J Bone Jt Surg Am 88(10):2279–2292. doi: 10.2106/JBJS.F.00125 Google Scholar
  10. 10.
    Bishop JY, Flatow EL (2005) Humeral head replacement versus total shoulder arthroplasty: clinical outcomes–a review. J Shoulder Elb Surg 14(1 Suppl S):141S–146S. doi: 10.1016/j.jse.2004.09.027 CrossRefGoogle Scholar
  11. 11.
    Bailie DS, Llinas PJ, Ellenbecker TS (2008) Cementless humeral resurfacing arthroplasty in active patients less than fifty-five years of age. J Bone Jt Surg Am 90(1):110–117CrossRefGoogle Scholar
  12. 12.
    Antuna SA, Sperling JW, Cofield RH, Rowland CM (2001) Glenoid revision surgery after total shoulder arthroplasty. J Shoulder Elb Surg 10(3):217–224. doi: 10.1067/mse.2001.113961 CrossRefGoogle Scholar
  13. 13.
    Levy O, Funk L, Sforza G, Copeland SA (2004) Copeland surface replacement arthroplasty of the shoulder in rheumatoid arthritis. J Bone Jt Surg Am 86-A(3):512–518CrossRefGoogle Scholar
  14. 14.
    Stewart MP, Kelly IG (1997) Total shoulder replacement in rheumatoid disease: 7- to 13-year follow-up of 37 joints. J Bone Jt Surg Br 79(1):68–72CrossRefGoogle Scholar
  15. 15.
    Deshmukh AV, Koris M, Zurakowski D, Thornhill TS (2005) Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elb Surg 14(5):471–479. doi: 10.1016/j.jse.2005.02.009 CrossRefGoogle Scholar
  16. 16.
    Cofield RH (1984) Total shoulder arthroplasty with the Neer prosthesis. J Bone Jt Surg Am 66(6):899–906CrossRefGoogle Scholar
  17. 17.
    Haines JF, Trail IA, Nuttall D, Birch A, Barrow A (2006) The results of arthroplasty in osteoarthritis of the shoulder. J Bone Jt Surg Br 88(4):496–501. doi: 10.1302/0301-620X.88B4.16604 CrossRefGoogle Scholar
  18. 18.
    Mullett H, Levy O, Raj D, Even T, Abraham R, Copeland SA (2007) Copeland surface replacement of the shoulder. Results of an hydroxyapatite-coated cementless implant in patients over 80 years of age. J Bone Jt Surg Br 89(11):1466–1469CrossRefGoogle Scholar
  19. 19.
    Levy O, Copeland SA (2001 Mar) Cementless surface replacement arthroplasty of the shoulder. 5- to 10-year results with the Copeland mark-2 prosthesis. J Bone Jt Surg Br 83(2):213–221CrossRefGoogle Scholar
  20. 20.
    Boileau P, Walch G, Noel E, Liotard JP (1994) Neer’s shoulder prosthesis: results according to etiology. Rev Rhum Ed Fr 61(9):607–618PubMedGoogle Scholar
  21. 21.
    Burgess DL, McGrath MS, Bonutti PM, Marker DR, Delanois RE, Mont MA (2009) Shoulder resurfacing. J Bone Jt Surg Am 91(5):1228–1238. doi: 10.2106/JBJS.H.01082 CrossRefGoogle Scholar
  22. 22.
    Levy O, Tsvieli O, Merchant J, Young L, Trimarchi A, Dattani R et al (2015) Surface replacement arthroplasty for glenohumeral arthropathy in patients aged younger than fifty years: results after a minimum ten-year follow-up. J Shoulder Elb Surg 24(7):1049–1060. doi: 10.1016/j.jse.2014.11.035 CrossRefGoogle Scholar
  23. 23.
    Levy O, Copeland SA (2004) Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder. J Shoulder Elb Surg 13(3):266–271CrossRefGoogle Scholar
  24. 24.
    Al-Hadithy N, Domos P, Sewell MD, Naleem A, Papanna MC, Pandit R (2012) Cementless surface replacement arthroplasty of the shoulder for osteoarthritis: results of fifty Mark III Copeland prosthesis from an independent center with four-year mean follow-up. J Shoulder Elb Surg 21(12):1776–1781. doi: 10.1016/j.jse.2012.01.024 CrossRefGoogle Scholar
  25. 25.
    Alizadehkhaiyat O, Kyriakos A, Singer MS, Frostick SP (2013) Outcome of Copeland shoulder resurfacing arthroplasty with a 4-year mean follow-up. J Shoulder Elbow Surg 22(10):1352–1358. doi: 10.1016/j.jse.2013.01.027 CrossRefPubMedGoogle Scholar
  26. 26.
    Geervliet P, van den Bekerom M, Spruyt P, Curvers M, Visser C, van Noort A (2014) Short-term results of the global C.A.P. uncemented resurfacing shoulder prosthesis. Orthopedics 37(1):42–47. doi: 10.3928/01477447-20131219-07 CrossRefPubMedGoogle Scholar
  27. 27.
    Thomas SR, Wilson AJ, Chambler A, Harding I, Thomas M (2005) Outcome of Copeland surface replacement shoulder arthroplasty. J Shoulder Elb Surg 14(5):485–491CrossRefGoogle Scholar
  28. 28.
    Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 14(6):756–760CrossRefPubMedGoogle Scholar
  29. 29.
    Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8(12):1153–1157CrossRefPubMedGoogle Scholar
  30. 30.
    Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG et al (1994) A standardized method for the assessment of shoulder function. J Shoulder Elb Surg 3(6):347–352. doi: 10.1016/S1058-2746(09)80019-0 CrossRefGoogle Scholar
  31. 31.
    van Kampen DA, van Beers LW, Scholtes VA, Terwee CB, Willems WJ (2011) Validation of the Dutch version of the Simple Shoulder Test. J Shoulder Elb Surg. doi: 10.1016/j.jse.2011.09.026
  32. 32.
    Blonna D, Scelsi M, Marini E, Bellato E, Tellini A, Rossi R et al (2012) Can we improve the reliability of the Constant-Murley score? J Shoulder Elb Surg 21(1):4–12. doi: 10.1016/j.jse.2011.07.014 CrossRefGoogle Scholar
  33. 33.
    Conboy VB, Morris RW, Kiss J, Carr AJ (1996) An evaluation of the Constant-Murley shoulder assessment. J Bone Jt Surg Br 78(2):229–232Google Scholar
  34. 34.
    Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164Google Scholar
  35. 35.
    Constant CR, Gerber C, Emery RJ, Sojbjerg JO, Gohlke F, Boileau P (2008) A review of the Constant score: modifications and guidelines for its use. J Shoulder Elb Surg 17(2):355–361. doi: 10.1016/j.jse.2007.06.022 CrossRefGoogle Scholar
  36. 36.
    Roy JS, MacDermid JC, Woodhouse LJ (2010) A systematic review of the psychometric properties of the Constant-Murley score. J Shoulder Elb Surg 19(1):157–164. doi: 10.1016/j.jse.2009.04.008 CrossRefGoogle Scholar
  37. 37.
    Katolik LI, Romeo AA, Cole BJ, Verma NN, Hayden JK, Bach BR (2005) Normalization of the Constant score. J Shoulder Elb Surg 14(3):279–285. doi: 10.1016/j.jse.2004.10.009 CrossRefGoogle Scholar
  38. 38.
    Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE et al (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51(11):1171–1178CrossRefPubMedGoogle Scholar
  39. 39.
    Jenkinson C, Layte R, Jenkinson D, Lawrence K, Petersen S, Paice C et al (1997) A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health Med 19(2):179–186CrossRefPubMedGoogle Scholar
  40. 40.
    Ware J Jr, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233CrossRefPubMedGoogle Scholar
  41. 41.
    Mechlenburg I, Amstrup A, Klebe T, Jacobsen SS, Teichert G, Stilling M (2013) The Copeland resurfacing humeral head implant does not restore humeral head anatomy. A retrospective study. Arch Orthop Trauma Surg 133(5):615–619. doi: 10.1007/s00402-013-1715-8 CrossRefPubMedGoogle Scholar
  42. 42.
    Bryant D, Litchfield R, Sandow M, Gartsman GM, Guyatt G, Kirkley A (2005) A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis. J Bone Jt Surg Am 87(9):1947–1956. doi: 10.2106/JBJS.D.02854 Google Scholar
  43. 43.
    Duan X, Zhang W, Dong X, Liu M, Gao Y, Huang F et al (2013) Total shoulder arthroplasty versus hemiarthroplasty in patients with shoulder osteoarthritis: a meta-analysis of randomized controlled trials. Semin Arthritis Rheum 43(3):297–302. doi: 10.1016/j.semarthrit.2013.04.002 CrossRefPubMedGoogle Scholar
  44. 44.
    Jain NB, Hocker S, Pietrobon R, Guller U, Bathia N, Higgins LD (2005) Total arthroplasty versus hemiarthroplasty for glenohumeral osteoarthritis: role of provider volume. J Shoulder Elb Surg 14(4):361–367. doi: 10.1016/j.jse.2004.10.007 CrossRefGoogle Scholar
  45. 45.
    Melis B, Bonnevialle N, Neyton L, Levigne C, Favard L, Walch G et al (2012) Glenoid loosening and failure in anatomical total shoulder arthroplasty: is revision with a reverse shoulder arthroplasty a reliable option? J Shoulder Elb Surg 21(3):342–349. doi: 10.1016/j.jse.2011.05.021 CrossRefGoogle Scholar
  46. 46.
    Cofield RH, Edgerton BC (1990) Total shoulder arthroplasty: complications and revision surgery. Instr Course Lect 39:449–462PubMedGoogle Scholar
  47. 47.
    Boileau P, Walch G (1997) The three-dimensional geometry of the proximal humerus. Implications for surgical technique and prosthetic design. J Bone Jt Surg Br 79(5):857–865CrossRefGoogle Scholar
  48. 48.
    Mansat P, Coutie AS, Bonnevialle N, Rongieres M, Mansat M, Bonnevialle P (2013) Resurfacing humeral prosthesis: do we really reconstruct the anatomy? J Shoulder Elb Surg 22(5):612–619. doi: 10.1016/j.jse.2012.07.014 CrossRefGoogle Scholar
  49. 49.
    Roberts SN, Foley AP, Swallow HM, Wallace WA, Coughlan DP (1991) The geometry of the humeral head and the design of prostheses. J Bone Jt Surg Br 73(4):647–650Google Scholar
  50. 50.
    Cofield RH (1983) Unconstrained total shoulder prostheses. Clin Orthop Relat Res 173:97–108Google Scholar
  51. 51.
    Geervliet PC, Houtveen M, Sierevelt IN, Visser C, van Noort A (2017) Revision from Global C.A.P. resurfacing prosthesis: results, survival and group comparison (Submitted for publication) Google Scholar
  52. 52.
    Geervliet PC, Somford MP, Winia P, van den Bekerom MP (2015) Long-term results of shoulder hemiarthroplasty in patients with rheumatoid arthritis. Orthopedics 38(1):e38–e42. doi: 10.3928/01477447-20150105-58 CrossRefPubMedGoogle Scholar
  53. 53.
    Groh GI, Wirth MA (2011 Jul) Results of revision from hemiarthroplasty to total shoulder arthroplasty utilizing modular component systems. J Shoulder Elb Surg 20(5):778–782. doi: 10.1016/j.jse.2010.09.014 CrossRefGoogle Scholar
  54. 54.
    Sanchez-Sotelo J (2011) Total shoulder arthroplasty. Open Orthop J 5:106–114. doi: 10.2174/1874325001105010106 CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Sperling JW, Cofield RH, Rowland CM (2004) Minimum fifteen-year follow-up of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged fifty years or younger. J Shoulder Elb Surg 13(6):604–613. doi: 10.1016/S1058274604001296 CrossRefGoogle Scholar
  56. 56.
    Ohl X, Nerot C, Saddiki R, Dehoux E (2010) Shoulder hemi arthroplasty radiological and clinical outcomes at more than two years follow-up. Orthop Traumatol Surg Res 96(3):208–215. doi: 10.1016/j.otsr.2010.01.001 CrossRefPubMedGoogle Scholar
  57. 57.
    Alolabi B, Youderian AR, Napolitano L, Szerlip BW, Evans PJ, Nowinski RJ et al (2014) Radiographic assessment of prosthetic humeral head size after anatomic shoulder arthroplasty. J Shoulder Elb Surg 23(11):1740–1746. doi: 10.1016/j.jse.2014.02.013 CrossRefGoogle Scholar
  58. 58.
    Orr TE, Carter DR (1985) Stress analyses of joint arthroplasty in the proximal humerus. J Orthop Res 3(3):360–371. doi: 10.1002/jor.1100030313 CrossRefPubMedGoogle Scholar
  59. 59.
    Pritchett JW (2011) Long-term results and patient satisfaction after shoulder resurfacing. J Shoulder Elb Surg 20(5):771–777. doi: 10.1016/j.jse.2010.08.014 CrossRefGoogle Scholar
  60. 60.
    Bonutti PM, Hawkins RJ (1992) Fracture of the humeral shaft associated with total replacement arthroplasty of the shoulder. A case report. J Bone Jt Surg Am 74(4):617–618CrossRefGoogle Scholar
  61. 61.
    Boyd AD Jr, Thornhill TS, Barnes CL (1992) Fractures adjacent to humeral prostheses. J Bone Jt Surg Am 74(10):1498–1504CrossRefGoogle Scholar
  62. 62.
    Groh GI, Heckman MM, Wirth MA, Curtis RJ, Rockwood CA Jr (2008) Treatment of fractures adjacent to humeral prostheses. J Shoulder Elb Surg 17(1):85–89. doi: 10.1016/j.jse.2007.05.007 CrossRefGoogle Scholar
  63. 63.
    Hawkins RJ, Bell RH, Jallay B (1989) Total shoulder arthroplasty. Clin Orthop Relat Res 242:188–194Google Scholar
  64. 64.
    Wirth MA, Rockwood CA Jr (1996) Complications of total shoulder-replacement arthroplasty. J Bone Jt Surg Am 78(4):603–616CrossRefGoogle Scholar
  65. 65.
    Streubel PN, Simone JP, Cofield RH, Sperling JW (2016) Revision of failed humeral head resurfacing arthroplasty. Int J Shoulder Surg 10(1):21–27. doi: 10.4103/0973-6042.174514 CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Rasmussen JV, Polk A, Sorensen AK, Olsen BS, Brorson S (2014) Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder: 837 operations reported to the Danish Shoulder Arthroplasty Registry. Bone Jt J Apr 96-B(4):519–525. doi: 10.1302/0301-620X.96B4.31850 CrossRefGoogle Scholar
  67. 67.
    Smith T, Gettmann A, Wellmann M, Pastor F, Struck M (2013) Humeral surface replacement for osteoarthritis. Acta Orthop 84(5):468–472. doi: 10.3109/17453674.2013.838658 CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Bartelt R, Sperling JW, Schleck CD, Cofield RH (2011) Shoulder arthroplasty in patients aged fifty-five years or younger with osteoarthritis. J Shoulder Elb Surg 20(1):123–130. doi: 10.1016/j.jse.2010.05.006 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • P. C. Geervliet
    • 1
    Email author
  • M. P. J. van den Bekerom
    • 2
  • P. Spruyt
    • 3
  • M. Curvers
    • 4
  • A. van Noort
    • 3
  • C. P. J. Visser
    • 4
  1. 1.Shoulder Unit, Department of Orthopedic SurgeryNorthWest ClinicsDen HelderThe Netherlands
  2. 2.Shoulder and Elbow Unit, Department of Orthopedic SurgeryOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
  3. 3.Department of Orthopedic SurgerySpaarne GasthuisHoofddorpThe Netherlands
  4. 4.Department of Orthopedic SurgeryAlrijne HospitalLeiderdorpThe Netherlands

Personalised recommendations