Hemiarthroplasty for the rotator cuff-deficient shoulder

Area of Science:

• Orthopedic Surgery
• Shoulder Reconstruction
• Joint Arthroplasty

Background:

• Hemiarthroplasty is a common surgical option for managing cuff tear arthropathy and glenohumeral arthritis.
• Limited data exists on the long-term outcomes and predictive factors for hemiarthroplasty in rotator cuff-deficient shoulders.

Purpose of the Study:

• To evaluate the long-term outcomes of hemiarthroplasty in patients with rotator cuff-deficient glenohumeral arthritis.
• To identify preoperative factors influencing the success of hemiarthroplasty.

Main Methods:

• A cohort of 31 patients (34 shoulders) with cuff tear arthropathy or massive rotator cuff tears underwent hemiarthroplasty.
• Outcomes were assessed using Neer criteria and the American Shoulder and Elbow Surgeons (ASES) score at a mean of 10 years postoperatively.

Main Results:

• Twenty-six of 34 shoulders met Neer criteria, with significant improvements in active forward elevation and external rotation.
• Patients with preoperative forward elevation ≥90 degrees demonstrated superior functional outcomes, pain relief, and overall ASES scores.
• The mean final ASES score was 67, with a low complication rate observed.

Conclusions:

• Hemiarthroplasty provides favorable long-term results for rotator cuff-deficient patients with glenohumeral arthritis.
• Preoperative active forward elevation of 90 degrees or more is a key predictor of successful outcomes.
• Hemiarthroplasty is a safe procedure with a low complication rate in this patient population.