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Humeral head resurfacing for fixed anterior glenohumeral dislocation

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Abstract

The purpose of this prospective study was to describe cementless humeral surface replacement arthroplasty (CHSRA) as a bone preserving treatment option for patients with fixed anterior glenohumeral dislocation. Ten patients with post-traumatic fixed anterior glenohumeral dislocation underwent CHSRA with a mean follow-up of 24 months. All patients were evaluated clinically using the Constant score and with radiographs in two planes. There were two reoperations: one patient developed glenoid erosion and was revised and in another case redislocation occurred. Clinical or radiographical signs of implant loosening were not found. The humeral head centred in the glenoid in nine out of ten cases radiographically. The Constant score increased from 20 points preoperatively to 61 points postoperatively (p < 0.007). CHSRA is a viable treatment option for elderly patients with fixed anterior glenohumeral dislocation and bone defects of the humeral head. Good clinical results and a moderate complication rate were found in the short term.

Résumé

Le sujet de cette étude prospective était de montrer que le resurfaçage sans ciment au niveau de l’épaule est un option permettant la préservation du capital osseux pour des patients avec une luxation antérieure chronique de l’épaule. Dix patients avec une luxation gléno humérale antérieure fixée ont subi un resurfaçage sans ciment avec un suivi moyen de 24 mois. Tous les patients ont été évalués cliniquement à l’aide du score de Constant et des radiographies dans deux plans. Deux réinterventions ont été nécessaires. Un patient a développé une érosion glénoïdienne nécessitant un changement de prothèse et un patient a récidivé sa luxation. Il n’y avait pas de signe clinique ou radiographique de descellement des implants. La tête humérale était centrée dans la glène dans 9 cas sur 10. Le score de constant s’est accru de 20 points en préopératoire à 61 points en post opératoire (p<0.007). Le resurfaçage huméral sans ciment est donc une solution fiable pour les patients âgés avec une luxation antérieure chronique et une encoche au niveau de la tête humérale. De bons résultats clinique et un taux de complications modéré ont été retrouvés à court terme.

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References

  1. Cheng SL, Mackay MB, Richards RR (1997) Treatment of locked posterior fracture-dislocations of the shoulder by total shoulder arthroplasty. J Shoulder Elbow Surg 6:11–17

    Article  PubMed  CAS  Google Scholar 

  2. Constant CR (1997) An evaluation of the Constant-Murley shoulder assessment. J Bone Joint Surg Br 79:695–696

    PubMed  CAS  Google Scholar 

  3. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–165

    Google Scholar 

  4. Gebhard F, Draeger M, Steinmann R, Hoellen I, Hartel W (1997) Functional outcome of Eden-Hybinette-Lange operation in post-traumatic recurrent shoulder dislocation. Unfallchirurg 100:770–775

    Article  PubMed  CAS  Google Scholar 

  5. Gerber C, Lambert SM (1996) Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder. J Bone Joint Surg Am 78:376–382

    PubMed  CAS  Google Scholar 

  6. Hawkins RJ, Neer CS, Pianta RM, Mendoza FX (1987) Locked posterior dislocation of the shoulder. J Bone Joint Surg Am 69:9–18

    PubMed  CAS  Google Scholar 

  7. Helfet AJ (1958) Coracoid transplantation for recurring dislocation of the shoulder. J Bone Joint Surg Br 40B:198–202

    Google Scholar 

  8. Hovelius L, Augustini BG, Fredin H, Johansson O, Norlin R, Thorling J (1996) Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study. J Bone Joint Surg Am 78:1677–1684

    PubMed  CAS  Google Scholar 

  9. Kronberg M, Brostrom LA (1991) Proximal humeral osteotomy to correct the anatomy in patients with recurrent shoulder dislocations. J Orthop Trauma 5:129–133

    Article  PubMed  CAS  Google Scholar 

  10. Kronberg M, Brostrom LA (1995) Rotation osteotomy of the proximal humerus to stabilise the shoulder. Five years' experience. J Bone Joint Surg Br 77:924–927

    PubMed  CAS  Google Scholar 

  11. Latarjet M (1954) Treatment of recurrent dislocation of the shoulder. Lyon Chir 49:994–997

    PubMed  CAS  Google Scholar 

  12. Levy O, Copeland SA (2001) Cementless surface replacement arthroplasty of the shoulder. 5- to 10-year results with the Copeland mark-2 prosthesis. J Bone Joint Surg Br 83:213–221

    Article  PubMed  CAS  Google Scholar 

  13. Levy O, Copeland SA (2004) Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder. J Shoulder Elbow Surg 13:266–271

    Article  PubMed  Google Scholar 

  14. Matsoukis J, Tabib W, Guiffault P, Mandelbaum A, Walch G, Nemoz C, Cortes ZE, Edwards TB (2006) Primary unconstrained shoulder arthroplasty in patients with a fixed anterior glenohumeral dislocation. J Bone Joint Surg Am 88:547–552

    Article  PubMed  CAS  Google Scholar 

  15. Neer CS, Foster CR (1980) Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg Am 62:897–908

    PubMed  Google Scholar 

  16. Neer CS, Watson KC, Stanton FJ (1982) Recent experience in total shoulder replacement. J Bone Joint Surg Am 64:319–337

    PubMed  Google Scholar 

  17. Pritchett JW, Clark JM (1987) Prosthetic replacement for chronic unreduced dislocations of the shoulder. Clin Orthop Relat Res 89–93

  18. Re P, Gallo RA, Richmond JC (2006) Transhumeral head plasty for large Hill-Sachs lesions. Arthroscopy 22:798

    Article  PubMed  Google Scholar 

  19. Rowe CR, Zarins B (1982) Chronic unreduced dislocations of the shoulder. J Bone Joint Surg Am 64:494–505

    PubMed  CAS  Google Scholar 

  20. Rowe CR, Zarins B, Ciullo JV (1984) Recurrent anterior dislocation of the shoulder after surgical repair. Apparent causes of failure and treatment. J Bone Joint Surg Am 66:159–168

    PubMed  CAS  Google Scholar 

  21. Sperling JW, Pring M, Antuna SA, Cofield RH (2004) Shoulder arthroplasty for locked posterior dislocation of the shoulder. J Shoulder Elbow Surg 13:522–527

    Article  PubMed  Google Scholar 

  22. Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 14:756–760

    Article  PubMed  CAS  Google Scholar 

  23. Weber BG, Simpson LA, Hardegger F (1984) Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion. J Bone Joint Surg Am 66:1443–1450

    PubMed  CAS  Google Scholar 

  24. Wehner W (1972) Eden-Hybinette-Lange surgical treatment of habitual shoulder dislocation. Zentralbl Chir 97:837–842

    PubMed  CAS  Google Scholar 

  25. Widjaja AB, Tran A, Bailey M, Proper S (2006) Correlation between Bankart and Hill-Sachs lesions in anterior shoulder dislocation. ANZ J Surg 76:436–438

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by the “Deutsche Arthrose-Hilfe e.V.”

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Authors and Affiliations

  1. Department of Shoulder and Elbow Surgery, Orthopaedic University Hospital of Heidelberg, Heidelberg, Germany

    P. Raiss, P. R. Aldinger, P. Kasten, M. Rickert & M. Loew

  2. Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200 A, 69118, Heidelberg, Germany

    P. Raiss

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  1. P. Raiss
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  2. P. R. Aldinger
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  3. P. Kasten
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  4. M. Rickert
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  5. M. Loew
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Correspondence to P. Raiss.

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The first and second authors contributed equally to this study.

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Raiss, P., Aldinger, P.R., Kasten, P. et al. Humeral head resurfacing for fixed anterior glenohumeral dislocation. International Orthopaedics (SICOT) 33, 451–456 (2009). https://doi.org/10.1007/s00264-007-0487-6

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  • DOI: https://doi.org/10.1007/s00264-007-0487-6

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