01-05-2015 | Shoulder
Arthroscopic partial shoulder resurfacing
Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2015
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Purpose
The purpose of this study was to report patients’ clinical and subjective outcomes 2 years after arthroscopic-assisted partial resurfacing of the humeral head.
Methods
In this prospective case series, 11 patients (4 females, 7 males; median age, 59 years; range 47–72) underwent arthroscopic-assisted partial shoulder resurfacing between April 2010 and March 2011. Clinical conditions and subjective assessments were evaluated before surgery and at 6 weeks, 3 and 6 months, and then annually after surgery using the Constant score (CS), active range of motion (ROM), the visual analogue scale (VAS) for pain, the American Shoulder and Elbow Surgeons scale (ASES), and the subjective shoulder value (SSV). Radiological outcomes and major complications were monitored.
Results
The mean CS improved significantly from 54.6 ± 13.6 preoperatively to 72.9 ± 17.2 points 6 weeks postoperatively (P = 0.009). At the 2-year follow-up, the mean CS had further increased to 86.5 ± 14.3 points (P < 0.001). Trends towards increasing ROMs were detected. VAS, ASES, and SSV significantly improved from baseline to the first follow-up and maintained improvement after 2 years. One patient required revision surgery owing to a technical failure and two patients because of rapidly progressive osteoarthritis. Ten of 11 patients (91 %) claimed that they would undergo arthroscopic partial shoulder resurfacing again.
Conclusion
Arthroscopic-assisted partial humeral head resurfacing, which has the advantages of bone stock preservation and the maintenance of an intact subscapularis tendon, allowed immediate postoperative mobilization and provided significant improvements in subjective outcomes, especially for pain relief in active patients without severe glenoid cartilage wear.
Level of evidence
Therapeutic case series, Level IV.