Outcome and revision rate of uncemented glenohumeral resurfacing (C.A.P.) after 5–8 years
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.
KeywordsShoulder Osteoarthritis Cementless Resurfacing Arthroplasty Humerus Glenoid
- 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.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
- 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
- 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
- 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
- 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.Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164Google Scholar
- 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
- 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.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
- 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
- 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.Cofield RH (1983) Unconstrained total shoulder prostheses. Clin Orthop Relat Res 173:97–108Google Scholar
- 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
- 63.Hawkins RJ, Bell RH, Jallay B (1989) Total shoulder arthroplasty. Clin Orthop Relat Res 242:188–194Google Scholar
- 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