scholarly journals Humeral Head Morphology Influences Outcomes of Arthroscopic Interposition Glenoid Patch Allograft for Glenohumeral Arthritis

2021 ◽  
Author(s):  
Brian M. Cable ◽  
Ali S. Farooqi ◽  
Steven Tsai ◽  
Ryan Plyler ◽  
Alex Lee ◽  
...  
Keyword(s):  
Humeral Head ◽  
Glenohumeral Arthritis ◽  
Head Morphology

scholarly journals Minimum 2 Years Outcomes of Powerlifters and Bodybuilders with advanced Glenohumeral arthritis, managed with Stemless aspherical humeral head resurfacing and inlay glenoid

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0041
Author(s):  
John Uribe ◽  
Zvijac Luis Vargas John
Keyword(s):  
Humeral Head ◽  
Intraoperative Complications ◽  
Total Shoulder Arthroplasty ◽  
Weight Lifting ◽  
Outpatient Basis ◽  
Glenohumeral Arthritis ◽  
Arthroscopic Capsular Release ◽  
The Mean ◽  
High Level

Objectives: Symptomatic glenohumeral arthritis (GHA) among high-level bodybuilders and powerlifters is relatively common. Once conservative management fails, the surgical options for these athletes are limited and pose challenges due to their relatively young age and the desire to continue their activities of weightlifting. The benefits of arthroscopic management are limited and short-lived. Hemi or Total shoulder arthroplasty remains controversial, and glenohumeral stresses upon return to even moderate lifting present an added risk for failure. A series of competitive or high-level recreational bodybuilders and powerlifters with advanced GHA who expressed a strong desire to continue their sport were managed utilizing a novel stemless aspherical resurfacing of the humeral head (HHR) combined with an inlay glenoid (IG). To our knowledge, there are no published studies documenting the efficacy of this unique approach. Methods: Our series consists of 18 shoulders corresponding to 14 male athletes with an average age of 45.6 years, range 25-57, who were prospectively followed. Pre- and postoperative evaluations included physical examination, radiographic assessment, the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form, the Western Ontario 0steoarthritis of the Shoulder Index (WOOS), pain visual analog scale (VAS-P), forward flexion (FF), external rotation (ER), internal rotation (IR) and patient satisfaction rating questionnaires. Results: All procedures were performed on an outpatient basis. No intraoperative complications were encountered, and no blood transfusions were required. The mean follow-up was 38 months, with a range (25-51). The mean ASES score improved from 26 to 93, and the mean WOOS score improved from 18 to 87. The mean VAS-P decreased from 9 to 1, mean FF increased from 115° to 145°, mean ER improved from 30 ° to 60° and IR improved from the level of the sacrum to L3. Eleven of the fourteen patients rated their preoperative shoulder satisfaction as poor. At last follow-up, all patients rated their shoulder as good to excellent. Radiographic follow-up revealed no evidence of component loosening, glenoid migration, or evidence of device failure. All patients were satisfied with the procedure and 12 / 14 returned to a moderate or higher level of weight lifting activities. One patient required an arthroscopic capsular release for arthrofibrosis which significantly improved function. Four of these patients requested contralateral surgery within six months of initial procedure. Conclusion: Stemless aspherical humeral head resurfacing combined with inlay glenoid replacement provides substantial pain relief and functional improvement and is a promising option for the management of symptomatic osteoarthritis in this challenging patient population. The procedure allows for a return to activities without restrictions and leaves multiple arthroplasty options if revision becomes necessary. Our results need to be reconfirmed in a larger cohort with longer follow-up.

Postsurgical Glenohumeral Arthritis in Young Adults

2009 ◽  
Vol 37 (9) ◽  
pp. 1784-1791 ◽  
Author(s):  
Allison G. McNickle ◽  
Daniel R. L'Heureux ◽  
Matthew T. Provencher ◽  
Anthony A. Romeo ◽  
Brian J. Cole
Keyword(s):  
Visual Analog Scale ◽  
Revision Surgery ◽  
Humeral Head ◽  
Short Form ◽  
Analog Scale ◽  
Simple Shoulder Test ◽  
Glenohumeral Arthritis ◽  
Additional Surgery ◽  
Biological Resurfacing ◽  
Mean Time

Background Chondrolysis has been reported as a sequela of arthroscopic shoulder surgery. Although the causes have yet to be fully elucidated, basic science and clinical evidence suggest a multifactorial origin. Surgical treatment in young patients with glenohumeral chondrolysis is particularly challenging, with little outcome data. Hypothesis Glenohumeral chondrolysis has several causes and patterns of presentation. Biological resurfacing is a viable treatment option for symptomatic glenohumeral arthritis. Study Design Case series; Level of evidence, 4. Methods Twenty patients (mean age, 19.7 years; range, 13.1-33.8) were referred for management of extensive glenohumeral arthritis after arthroscopy glenohumeral surgery (mean time postoperatively, 26 months; range, 3-73). Sixteen patients had an intra-articular pain pump placed for 2 to 3 days; 2 patients demonstrated prominent implants; and 2 had thermal treatment. Patients underwent revision surgery, including 7 biological resurfacings of the glenoid and humeral head, 4 biological resurfacings of the humeral head alone, and 7 other procedures. Eight patients having biological resurfacing were assessed just before the revision surgery, at a mean time of 3.1 years after revision (range, 1.9-6.5), with the American Shoulder and Elbow Surgeon scale and Simple Shoulder Test, Short Form 12 (physical and mental components), and visual analog scale score for pain. Results Patient outcomes scores improved from 51 to 71 (American Shoulder and Elbow Surgeon scale, P < .01), 7 to 10 (Simple Shoulder Test, P < .02), and 5 to 3 (visual analog scale, P < .01). Preoperative range of motion demonstrated modest improvements from 119° to 132° of flexion, 42° to 41° of external rotation, and internal rotation from L2 to T12 level. Two patients required an additional surgery: 1 total shoulder arthroplasty and 1 capsular release with debridement. Conclusion Severe glenohumeral arthritis is a devastating postoperative complication of glenohumeral arthroscopy. Although not a universal finding, the use of glenohumeral pain pumps is a concern, as well as suboptimal anchor placement. Biological resurfacing permits modest functional improvement in a challenging shoulder condition.

scholarly journals Aequalis Humeral Head Resurfacing in Glenohumeral Arthritis at a Minimum Followup of 2 Years

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Roshan Raghavan ◽  
Amitabh J. Dwyer ◽  
Andrew F. W. Chambler
Keyword(s):  
Humeral Head ◽  
Assessment Tool ◽  
Shoulder Function ◽  
Inclusion Criteria ◽  
Oxford Shoulder Score ◽  
Glenohumeral Arthritis ◽  
Reliable Procedure ◽  
The Mean ◽  
Minimum Followup ◽  
End Stage

Aim. To evaluate results of Aequalis humeral head resurfacing in patients with end-stage glenohumeral arthritis at a minimum followup of two years. Patients and Methods. Twenty-one consecutive patients underwent humeral head resurfacing hemiarthroplasty between 2007 and 2009. Three patients did not fulfill the inclusion criteria. 18 patients with mean age of 75.1 years (range 58–91 years) and a mean duration of preoperative symptoms of 33.6 months (range 6–120 months) were analyzed. Patients’ self-reported Oxford shoulder score (OSS) was collected prospectively and was used as an assessment tool to measure final outcome. Results. The mean initial OSS was 15 (range 3–29). The score improved by an average of 19.5 points at a mean followup of 36.3 months (range 24–54 months) to reach a mean final OSS of 34.5 (range 6–47). The improvement of OSS was highly significant with a two-tailed P value less than 0.0001. The overall patient satisfaction was 94%. Conclusion. This study demonstrates Aequalis shoulder resurfacing hemiarthroplasty as a reliable procedure, away from its originating center, for improvement of shoulder function as shown by the patients’ self-reported outcome score (OSS) in end-stage glenohumeral arthritis at a minimum followup of 2 years.

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

2014 ◽  
Vol 23 (8) ◽  
pp. e185-e190 ◽  
Author(s):  
Stephanie J. Muh ◽  
Jonathan J. Streit ◽  
Yousef Shishani ◽  
Samuel Dubrow ◽  
Robert J. Nowinski ◽  
...  
Keyword(s):  
Young Patient ◽  
Humeral Head ◽  
Glenohumeral Arthritis

Successful Treatment of Congenital Shoulder Luxation in a Dog by Closed Pinning

1994 ◽  
Vol 07 (04) ◽  
pp. 170-172 ◽  
Author(s):  
R. A. Read
Keyword(s):  
Early Diagnosis ◽  
Successful Treatment ◽  
Humeral Head ◽  
One Year

Congenital shoulder luxation in the dog is commonly associated with deformity of the humeral head and glenoid, making reduction and stabilization difficult. Early diagnosis of congenital luxation of the shoulder in a Papillon made it possible to successfully reduce and stabilize the luxation using a closed pinning technique. One year later the joint was functionally and radiographically normal.

scholarly journals Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Noboru Matsumura ◽  
Kazuya Kaneda ◽  
Satoshi Oki ◽  
Hiroo Kimura ◽  
Taku Suzuki ◽  
...  
Keyword(s):  
Humeral Head ◽  
Glenohumeral Joint ◽  
Three Dimensional ◽  
Clinical Results ◽  
Bone Defects ◽  
Symptom Duration ◽  
Glenohumeral Instability ◽  
Explanatory Variables ◽  
Large Bone ◽  
Large Bone Defects

Abstract Background Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. Methods A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. Results Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). Conclusions Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations.

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