Monday, July 8, 2013

Partial humeral head resurfacing - Arthrosurface

The concept behind partial humeral head resurfacing arthroplasty is to use a tack-like device to manage a humeral head defect. These authors report on 39 shoulders with focal chondral defects of the humeral head treated with partial resurfacing arthroplasty. Almost all had had prior surgical procedures on the shoulder. Many had other pathologies in addition to the loss of cartilage. These individuals were young (45.6 years (range, 27-76 years)). 

Of these 39 shoulders only 25 showed functional improvement. Six patients required revision and another 4 were recommended to have revision.

While this procedure attempts to preserve as much of the native humeral head as possible, the problems are (1) it is uncommon to have to have only a small part of the articular surface affected by arthritis, (2) with segmental damage from avascular necrosis, the underlying bone is not normal and may compromise the quality of Arthrosurface fixation, and (3) the mechanical properties of the metal joint surface are in marked contrast to that of the surrounding articular cartilage.

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