The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Total Shoulder Arthroplasty is associated With Less Pain and Better Functional Outcomes, but Humeral Head Resurfacing may be Preferred in Younger, Higher Demand Patients: A Short-Term Outcomes Study in Patients with Glenohumeral Osteoarthritis

Document Type : RESEARCH PAPER

Authors
Ehab M. Nazzal 1
Rajiv P. Reddy 1
David A. Solomon 2
Jonathan D. Hughes 1
James G. Rooney 1
Mitchell S. Fourman 3
David Hirsch 4
Mark W. Rodosky 1
Albert Lin 1
1 Freddie Fu Sports Medicine Center- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
2 Summit Health Orthopaedics, Florham Park, NJ, USA
3 Hospital for Special Surgery, New York, NY, USA
4 Rothman Orthopaedics, Orlando, FL, USA
10.22038/abjs.2024.72211.3364
Abstract
Objectives: This study aimed to compare short-term outcomes following Total Shoulder Arthroplasty 
(TSA) and Humeral Head Resurfacing (HHR) in patients with glenohumeral osteoarthritis (GHOA).
Methods: A retrospective analysis included patients who had undergone either TSA or HHR for GHOA at a single 
institution. Baseline demographics, complications, range of motion (active forward flexion, FF and active external 
rotation, ER), visual analog scores (VAS), and Subjective Shoulder Values (SSV) were collected.
Results: A total of 69 TSA and 56 HHR patients were analyzed. More HHR patients were laborers (44% versus 
21%, P=0.01). There were more smokers in the TSA group (25% versus 11%, P=0.04) and more cardiovascular 
disease in the HHR cohort (64% versus. 6%, p<0.0001). Postoperative FF was similar, but ER was greater in the 
HHR (47° ± 15°) vs. TSA group (40° ± 12°, P = 0.01). VAS was lower after TSA vs. HHR (median 0, IQR 1 versus 
median 3.7, IQR 6.9, p<0.0001), and SSV was higher after TSA (89% ± 13% vs. 75% ± 20% after HHR; p<0.0001). 
Post-operative impingement was more common after HHR (32% vs. 3% for TSA, p<0.0001). All other complications 
were equivalent.
Conclusion: While younger patients and heavy laborers had improved ER following HHR, their pain relief was 
greater after TSA. Decisions on surgical technique should be based on patient-specific demographic and anatomic 
factors.
 Level of evidence: III
Keywords
Humeral head resurfacing
Resurfacing hemiarthroplasty
Short-term follow-up
Shoulder osteoarthritis
Total shoulder arthroplasty
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 6
June 2024
Pages 400-406

  • Receive Date 11 May 2023
  • Revise Date 26 April 2024
  • Accept Date 17 April 2024