Skip to main content
SpringerLink
Log in

Shoulder Arthroplasty for Humeral Head Osteonecrosis

  • Chapter
Rotator Cuff Across the Life Span

  • 1116 Accesses

Abstract

Osteonecrosis (ON) of the humeral head (HH) is a significant cause of shoulder pain and arthritis, albeit much less common than ON of the hip. Diagnosis and treatment of ON of the HH may be delayed due to increased mobility of adjacent joints and lack of weight-bearing on the shoulder. The Cruess classification continues to be the most widely used staging system for this disease, and treatment depends on stage. Corticosteroid use is the most common cause of atraumatic ON, followed by alcoholism, hemoglobinopathies, and lipid storage disorders. Nonoperative treatment and core decompression still play a role in early treatment, with hemiarthroplasty and total shoulder arthroplasty (TSA) reserved for advanced cases with HH collapse and/or glenoid arthrosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Cruess RL. Steroid-induced avascular necrosis of the head of the humerus. Natural history and management. J Bone Joint Surg Br. 1976;58:313–7.

    CAS  PubMed  Google Scholar 

  2. Hattrup SJ, Cofield RH. Osteonecrosis of the humeral head: relationship of disease stage, extent, and cause to natural history. J shoulder Elb Surg. 1999;8:559–64.

    CAS  Google Scholar 

  3. Milner PF, Kraus AP, Sebes JI, Sleeper LA, Dukes KA, Embury SH, Bellevue R, Koshy M, Moohr JW, Smith J. Osteonecrosis of the humeral head in sickle cell disease. Clin Orthop Relat Res. 1993;289:136–43.

    Google Scholar 

  4. Jacobs B. Epidemiology of traumatic and nontraumatic osteonecrosis. Clin Orthop Relat Res. 1978;130:51–67.

    Google Scholar 

  5. L’Insalata JC, Pagnani MJ, Warren RF, Dines DM. Humeral head osteonecrosis: clinical course and radiographic predictors of outcome. J shoulder Elb Surg. 1996;5:355–61.

    Google Scholar 

  6. Hungerford DS, Lennox DW. The importance of increased intraosseous pressure in the development of osteonecrosis of the femoral head: implications for treatment. Orthop Clin North Am. 1985;16:635–54.

    CAS  PubMed  Google Scholar 

  7. Jones JP, Engleman EP, Najarian JS. Systemic fat embolism after renal homotransplantation and treatment with corticosteroids. N Engl J Med. 1965;273:1453–8.

    PubMed  Google Scholar 

  8. Laroche M, Arlet J, Mazieres B. Osteonecrosis of the femoral and humeral heads after intraarticular corticosteroid injections. J Rheumatol. 1990;17:549–51.

    CAS  PubMed  Google Scholar 

  9. Dilisio MF. Osteonecrosis following short-term, low-dose oral corticosteroids: a population-based study of 24 million patients. Orthopedics. 2014;37:e631–6.

    PubMed  Google Scholar 

  10. Chang CC, Greenspan A, Gershwin ME. Osteonecrosis: current perspectives on pathogenesis and treatment. Semin Arthritis Rheum. 1993;23:47–69.

    CAS  PubMed  Google Scholar 

  11. Matsuo K, Hirohata T, Sugioka Y, Ikeda M, Fukuda A. Influence of alcohol intake, cigarette smoking, and occupational status on idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res. 1988;234:115–23.

    Google Scholar 

  12. Mont MA, Payman RK, Laporte DM, Petri M, Jones LC, Hungerford DS. Atraumatic osteonecrosis of the humeral head. J Rheumatol. 2000;27:1766–73.

    CAS  PubMed  Google Scholar 

  13. Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br. 1985;67:3–9.

    CAS  PubMed  Google Scholar 

  14. Schroer WC. Current concepts on the pathogenesis of osteonecrosis of the femoral head. Orthop Rev. 1994;23:487–97.

    CAS  PubMed  Google Scholar 

  15. Harreld KL, Marker DR, Wiesler ER, Shafiq B, Mont MA. Osteonecrosis of the Humeral. J Am Acad Orthop Surg. 2009;17:345–55.

    PubMed  Google Scholar 

  16. Hayes JM. Arthroscopic treatment of steroid-induced osteonecrosis of the humeral head. Arthroscopy. 1989;5:218–21.

    CAS  PubMed  Google Scholar 

  17. Hardy P, Decrette E, Jeanrot C, Colom A, Lortat-Jacob A, Benoit J. Arthroscopic treatment of bilateral humeral head osteonecrosis. Arthroscopy. 2000;16:332–5.

    CAS  PubMed  Google Scholar 

  18. LaPorte DM, Mont MA, Mohan V, Pierre-Jacques H, Jones LC, Hungerford DS. Osteonecrosis of the humeral head treated by core decompression. Clin Orthop Relat Res. 1998;14:254–60.

    Google Scholar 

  19. Harreld KL, Marulanda GA, Ulrich SD, Marker DR, Seyler TM, Mont MA. Small-diameter percutaneous decompression for osteonecrosis of the shoulder. Am J Orthop (Belle Mead NJ). 2009;38:348–54.

    Google Scholar 

  20. Mont MA, Maar DC, Urquhart MW, Lennox D, Hungerford DS. Avascular necrosis of the humeral head treated by core decompression. A retrospective review. J Bone Joint Surg Br. 1993;75:785–8.

    CAS  PubMed  Google Scholar 

  21. Chapman C, Mattern C, Levine WN. Arthroscopically assisted core decompression of the proximal humerus for avascular necrosis. Arthroscopy. 2004;20:1003–6.

    PubMed  Google Scholar 

  22. Dines JS, Strauss EJ, Fealy S, Craig EV. Arthroscopic-assisted core decompression of the humeral head. Arthrosc J Arthrosc Relat Surg. 2007;23:103.e1–4.

    Google Scholar 

  23. Yajima H, Tamai S, Ono H, Kizaki K. Vascularized bone grafts to the upper extremities. Plast Reconstr Surg. 1998;101:727–35.. discussion 736–7.

    CAS  PubMed  Google Scholar 

  24. Rindell K. Muscle pedicled bone graft in revascularization of aseptic necrosis of the humeral head. Ann Chir Gynaecol. 1987;76:283–5.

    CAS  PubMed  Google Scholar 

  25. Nakagawa Y, Ueo T, Nakamura T. A novel surgical procedure for osteonecrosis of the humeral head: reposition of the joint surface and bone engraftment. Arthroscopy. 1999;15:433–8.

    CAS  PubMed  Google Scholar 

  26. Neer CS. Articular replacement for the humeral head. J Bone Joint Surg Am. 1955;37-A:215–28.

    PubMed  Google Scholar 

  27. Kay SP, Amstutz HC. Shoulder hemiarthroplasty at UCLA. Clin Orthop Relat Res. 1988;22:42–8.

    Google Scholar 

  28. Boyd AD, Thomas WH, Scott RD, Sledge CB, Thornhill TS. Total shoulder arthroplasty versus hemiarthroplasty. Indications for glenoid resurfacing. J Arthroplasty. 1990;5:329–36.

    PubMed  Google Scholar 

  29. Amstutz HC, Thomas BJ, Kabo JM, Jinnah RH, Dorey FJ. The Dana total shoulder arthroplasty. J Bone Joint Surg Am. 1988;70:1174–82.

    CAS  PubMed  Google Scholar 

  30. Scalise JJ, Miniaci A, Iannotti JP. Resurfacing arthroplasty of the humerus: indications, surgical technique, and clinical results. Tech Shoulder Elb Surg. 2007;8:152–60.

    Google Scholar 

  31. Uribe JW, Botto-van Bemden A. Partial humeral head resurfacing for osteonecrosis. J shoulder Elb Surg. 2009;18:711–6.

    Google Scholar 

  32. Raiss P, Kasten P, Baumann F, Moser M, Rickert M, Loew M. Treatment of osteonecrosis of the humeral head with cementless surface replacement arthroplasty. J Bone Joint Surg Am. 2009;91:340–9.

    PubMed  Google Scholar 

  33. Hattrup SJ, Cofield RH. Osteonecrosis of the humeral head: results of replacement. J shoulder Elb Surg. 2000;9:177–82.

    CAS  Google Scholar 

  34. Mansat P, Huser L, Mansat M, Bellumore Y, Rongières M, Bonnevialle P. Shoulder arthroplasty for atraumatic avascular necrosis of the humeral head: nineteen shoulders followed up for a mean of seven years. J shoulder Elb Surg. 2005;14:114–20.

    Google Scholar 

  35. Orfaly RM, Rockwood CA, Esenyel CZ, Wirth MA. Shoulder arthroplasty in cases with avascular necrosis of the humeral head. J Shoulder Elb Surg. 2007;16:S27–32.

    Google Scholar 

  36. Parsch D, Lehner B, Loew M. Shoulder arthroplasty in nontraumatic osteonecrosis of the humeral head. J shoulder Elb Surg. 2003;12:226–30.

    Google Scholar 

  37. Tyrrell Burrus M, Cancienne JM, Boatright JD, Yang S, Brockmeier SF, Werner BC. Shoulder arthroplasty for humeral head avascular necrosis is associated with increased postoperative complications. HSS J. 2018;14:2–8.

    PubMed  Google Scholar 

  38. Baulot E, Garron E, Grammont PM. Grammont prosthesis in humeral head osteonecrosis. Indications—results. Acta Orthop Belg. 1999;65(Suppl 1):109–15.

    PubMed  Google Scholar 

  39. Lau MW, Blinder MA, Williams K, Galatz LM. Shoulder arthroplasty in sickle cell patients with humeral head avascular necrosis. J shoulder Elb Surg. 2007;16:129–34.

    Google Scholar 

  40. Kennon JC, Smith JP, Crosby LA. Core decompression and arthroplasty outcomes for atraumatic osteonecrosis of the humeral head. J Shoulder Elb Surg. 2016;25:1442–8.

    Google Scholar 

  41. Topolski MS, Chin PYKK, Sperling JW, Cofield RH. Revision shoulder arthroplasty with positive intraoperative cultures: the value of preoperative studies and intraoperative histology. J Shoulder Elb Surg. 2006;15:402–6.

    Google Scholar 

  42. Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Molé D. Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elb Surg. 2002;11:401–12.

    CAS  Google Scholar 

  43. Dines DM, Warren RF, Altchek DW, Moeckel B. Posttraumatic changes of the proximal humerus: malunion, nonunion, and osteonecrosis. Treatment with modular hemiarthroplasty or total shoulder arthroplasty. J Shoulder Elb Surg. 1993;2:11–21.

    CAS  Google Scholar 

  44. Moineau G, McClelland WB, Trojani C, Rumian A, Walch G, Boileau P. Prognostic factors and limitations of anatomic shoulder arthroplasty for the treatment of posttraumatic cephalic collapse or necrosis (type-1 proximal humeral fracture sequelae). J Bone Joint Surg Am. 2012;94:2186–94.

    PubMed  Google Scholar 

  45. Jost B, Spross C, Grehn H, Gerber C. Locking plate fixation of fractures of the proximal humerus: analysis of complications, revision strategies and outcome. J Shoulder Elb Surg. 2013;22:542–9.

    Google Scholar 

  46. Dilisio MF, Noble JS, Bell RH, Noel CR. Postarthroscopic humeral head osteonecrosis treated with reverse total shoulder arthroplasty. Orthopedics. 2013;36:e377–80.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA

    Jason C. Ho & Michael A. Stone

  2. Rothman Orthopaedic Institute, New York, NY, USA

    Meghan E. Bishop, Brandon J. Erickson & Anthony A. Romeo

Authors
  1. Jason C. Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael A. Stone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meghan E. Bishop
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brandon J. Erickson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anthony A. Romeo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anthony A. Romeo .

Editor information

Editors and Affiliations

  1. Orthopaedic Sportsmedicine, University of Munich (TUM), Orthopaedic Sportsmedicine, Munich, Bayern, Germany

    Andreas B. Imhoff

  2. Department of Orthopaedics, Tulane University School of Medicine, Department of Orthopaedics, New Orleans, LA, USA

    Felix H. Savoie III

Rights and permissions

Reprints and permissions

Copyright information

© 2019 ISAKOS

About this chapter

Cite this chapter

Ho, J.C., Stone, M.A., Bishop, M.E., Erickson, B.J., Romeo, A.A. (2019). Shoulder Arthroplasty for Humeral Head Osteonecrosis. In: Imhoff, A.B., Savoie, F.H. (eds) Rotator Cuff Across the Life Span. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58729-4_51

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-58729-4_51

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58728-7

  • Online ISBN: 978-3-662-58729-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation