Original ArticleHemiarthroplasty and total shoulder arthroplasty for avascular necrosis of the humeral head
Section snippets
Materials and methods
A retrospective study was performed following approval from the institutional review board. From 1989 to 1997, a total of 845 shoulder arthroplasties were performed. Eighty-four were for osteonecrosis. There were 64 patients, treated by 4 surgeons, who were available for this study. The remaining 20 were lost to follow-up. The 64 were reviewed at a mean of 4.8 years (range, 2-7.2). There were 38 men and 26 women. The mean age at the time of surgery was 57 years (range, 46-77 years).
The most
Results
There were 64 shoulders with a mean age of 57 years of age. The average follow-up was 4.8 years. The average ASES score was 67 ± 6.2 and the average L'Insalata score was 64.7 ± 5.9. The average flexion was 127 ± 12.0°, external rotation was 49 ± 3.9°, and internal rotation was to L1. All but one patient was satisfied with their surgery and would have the surgery again.
There was no statistical difference in ASES and L'Insalata scores based on etiology of osteonecrosis (Table II). Sickle cell
Discussion
Shoulder arthroplasty is a reliable treatment for primary osteoarthritis, as well as rheumatoid arthritis, post-traumatic arthritis, and osteonecrosis.13, 25, 26 Osteonecrosis accounts for approximately 5% of all shoulder arthroplasties performed. However, there have been relatively few studies that evaluate the outcomes following arthroplasty for osteonecrosis of the humeral head, and many of them have few cases or only short-term follow-up.1, 4, 9, 12, 17 As patients with osteonecrosis tend
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Comment on Na et al.: Outcomes and complications after arthroplasty in patients with osteonecrosis of humeral head- systematic review
2024, Journal of Orthopaedic ScienceCore decompression is superior to nonoperative management for humeral head osteonecrosis: a systematic review
2023, Journal of Shoulder and Elbow SurgeryOutcomes and complications after arthroplasty in patients with osteonecrosis of humeral head- systematic review
2023, Journal of Orthopaedic ScienceCitation Excerpt :External rotation improved from 22.7° to 52.8° in all arthroplasties [8,14,15,17,18,21,22], from 32.6° to 61.3° in HA [8,21,22], and from 22.0° to 53.0° in TSA [21]. Internal rotation improved from L4 level to L2 level in all arthroplasties [8,14,17,18,21,22], from L4 level to L3 level in HA [8,21,22], and from L5 level to L3 level in TSA [21]. Overall complication rate was 20.0% (91/456) in all arthroplasties [8,14–22] including 10.1% (16/158) in HA [14,16–18,20,21] and 17.5% (21/120) in TSA (p = 0.077) (Tables 3 and 4) [14,16–18,20,21].
Diagnosis and treatment of avascular necrosis of the humeral head: Current concepts
2023, Journal of ISAKOSHemiarthroplasty for nontraumatic avascular necrosis of the humeral head is associated with low complications and reoperation rates
2023, Seminars in Arthroplasty JSESCitation Excerpt :This suggests that revision rates for hemiarthroplasty in nontraumatic AVN may be significantly lower than those for posttraumatic AVN. These results appear consistent with the broader orthopedic literature, wherein arthroplasties performed for posttraumatic conditions, be it at the shoulder, elbow, or hip, typically have higher failure rates than those for primary arthritis.2,4,10,20 Overall, the postoperative ROM of our patients was satisfactory, comparable to or better than what has been previously published in the literature.18
Survivorship of total shoulder arthroplasty vs. hemiarthroplasty for the treatment of avascular necrosis at greater than 10-year follow-up
2022, Journal of Shoulder and Elbow Surgery