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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Research article

Overstuffing in resurfacing hemiarthroplasty is a potential risk for failure

Authors: Pieter C. Geervliet, Jore H. Willems, Inger N. Sierevelt, Cornelis P. J. Visser, Arthur van Noort

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

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Abstract

Purpose

Literature describes the concern of an overstuffed shoulder joint after a resurfacing humeral head implant (RHHI). The purpose of this study was to evaluate inter-observer variability of (1) the critical shoulder angle (CSA), (2) the length of the gleno-humeral offset (LGHO), and (3) the anatomic center of rotation (COR) in a patient population operated with a Global Conservative Anatomic Prosthesis (CAP) RHHI. The measurements were compared between the revision and non-revision groups to find predictive indicators for failure.

Methods

Pre- and postoperative radiographs were retrieved from 48 patients who underwent RHHI from 2007 to 2009 using a Global CAP hemiarthroplasty for end-stage osteoarthritis. This cohort consisted of 36 females (12 men) with a mean age of 77 years (SD 7.5). Two musculoskeletal radiologist and two specialized shoulder orthopedic surgeons measured the CSA, LGHO, and COR of all patients.

Results

The inter-observer reliability showed excellent reliability for the CSA, LGHO, and the COR, varying between 0.91 and 0.98. The mean COR of the non-revision group was 4.9 mm (SD 2.5) compared to mean COR of the revision group, 8 mm (SD 2.2) (p < 0.01). The COR is the predictor of failure (OR 1.90 (95%Cl 1.19–3.02)) with a cut of point of 5.8 mm. The mean CSA was 29.8° (SD 3.9) There was no significant difference between the revision and non-revision groups (p = 0.34). The mean LGHO was 2.6 mm (SD 3.3) post-surgery. The mean LGHO of the revision group was 3.9 (SD 1.7) (p = 0.04) post-surgery. Despite the difference in mean LGHO, this is not a predictor for failure.

Conclusion

The CSA, LGHO, and COR can be used on radiographs and have a high inter-observer agreement. In contrast with the CSA and LGHO, we found a correlation between clinical failure and revision surgery in case of a deviation of the COR greater than 5 mm.

Trial registration

Institutional review board, number: ACLU 2016.0054, Ethical Committee number: CBP M1330348. Registered 7 November 2006.
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Metadata
Title
Overstuffing in resurfacing hemiarthroplasty is a potential risk for failure
Authors
Pieter C. Geervliet
Jore H. Willems
Inger N. Sierevelt
Cornelis P. J. Visser
Arthur van Noort
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1522-1

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