Humeral resurfacing arthroplasty: rationale, indications, technique, and results

Humeral head resurfacing arthroplasty has evolved into a reliable method of shoulder arthroplasty designed to restore the natural anatomy of an arthritic or damaged articular humeral surface. Recent implant changes have improved the ability of the surface replacement implants to recreate the humeral head surface and the initial implant fixation. Instrument changes have improved the ability to place the implant in the anatomical position that recreates an individual's humeral articular surface posterior offset, neck-shaft angle, and version. These implant and instrument changes have led to a more refined surgical technique that avoids the complications associated with use of stemmed implants. Minimal bone resection occurs in shoulder resurfacing arthroplasty--the result being bone stock preservation, which is important in active or young patients with shoulder arthritis. Cementless surface replacements have been shown to provide results comparable to those of stemmed implants similar in diagnosis and follow-up. In this article, I outline the current rationale for resurfacing arthroplasty implants and the indications for their use. I also present the surgical technique and review the results of proximal humeral resurfacing arthroplasty.