Monday, January 27, 2014

Biological resurfacing with Graftjacket or Achilles tendon and Hemiarthroplasty or Arthrosurface in young patients with shoulder arthritis

Biologic resurfacing of the glenoid with humeral head resurfacing for glenohumeral arthritis in the young patient

These authors explored resurfacing of the glenoid with an interposition soft tissue graft in conjunction with humeral head arthroplasty as an option to improve glenohumeral arthritis in young patients while avoiding the potential complications associated with total shoulder arthroplasty.

They performed a multicenter review of 16 patients who had undergone humeral head arthroplasty with soft tissue interposition grafting of the glenoid. Patient age averaged 36.1 years (range, 14-45 years).All patients had a minimum follow-up time of 24 months, unless revision surgery was required because of failure of the procedure.

16 patients had a mean follow-up of 60 months. 7 patients (44%) required revision to a total shoulder at a mean of 36 months.

The authors conclude that because of the limited improvement in patient outcomes and the high revision rate, biologic resurfacing of the glenoid with humeral head resurfacing is no longer their primary treatment option for young patients and should be used with caution. These results are similar to those presented in another recent article.

Comment: We continue offer a ream and run procedure to carefully selected active patients who desire a level of activity beyond that recommended for a total shoulder arthroplasty.

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