Humeral head resurfacing for fixed anterior glenohumeral dislocation

Abstract

The purpose of this prospective study was to describe cementless humeral surface replacement arthroplasty (CHSRA) as a bone preserving treatment option for patients with fixed anterior glenohumeral dislocation. Ten patients with post-traumatic fixed anterior glenohumeral dislocation underwent CHSRA with a mean follow-up of 24 months. All patients were evaluated clinically using the Constant score and with radiographs in two planes. There were two reoperations: one patient developed glenoid erosion and was revised and in another case redislocation occurred. Clinical or radiographical signs of implant loosening were not found. The humeral head centred in the glenoid in nine out of ten cases radiographically. The Constant score increased from 20 points preoperatively to 61 points postoperatively (p < 0.007). CHSRA is a viable treatment option for elderly patients with fixed anterior glenohumeral dislocation and bone defects of the humeral head. Good clinical results and a moderate complication rate were found in the short term.

Fig. 1

Anteriorposterior radiograph of a 65-year-old male 8 weeks after trauma with a fixed anterior glenohumeral dislocation (patient 10, Table 1)

Fig. 2

Axillary radiograph of a 65-year-old male 8 weeks after trauma with a fixed anterior glenohumeral dislocation (patient 10, Table 1)

Fig. 3

Preoperative CT scan of a fixed anterior glenohumeral dislocation; size of the humeral head defect was calculated as 25% (patient 7, Table 1)

Fig. 4

Intraoperative documentation of a bone defect after preparing the humeral head with hemispherical reamers

Fig. 5

Anteriorposterior radiograph of patient 10 (Table 1), 12 months after arthroplasty

Fig. 6

Axillary radiograph of patient 10 (Table 1), 12 months after arthroplasty