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Hemiarthroplasty in rotator cuff-deficient shoulders
1Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Journal of Shoulder and Elbow Surgery
|September 1, 1996
Summary
Neer humeral hemiarthroplasty improved pain and function in patients with severe rotator cuff tears and arthritis. This procedure offers a viable alternative to other surgical options for this challenging patient group.
Area of Science:
- Orthopedic Surgery
- Shoulder Reconstruction
- Prosthetic Joint Replacement
Background:
- Combined glenohumeral arthritis and irreparable rotator cuff tears present a significant surgical challenge.
- Traditional treatment options may be limited or lead to poor outcomes in these complex cases.
Purpose of the Study:
- To evaluate the outcomes of Neer humeral hemiarthroplasty in patients with combined glenohumeral arthritis and complete rotator cuff defects.
- To assess pain reduction, functional improvement, and stability following the procedure.
Main Methods:
- A retrospective review of 20 patients (21 shoulders) who underwent Neer humeral hemiarthroplasty between 1974 and 1990.
- Preservation of the coracoacromial ligament and aggressive deltoid rehabilitation were employed.
- Two patients received pectoralis major transfer for subscapularis insufficiency.
Main Results:
- 86% of shoulders achieved satisfactory results based on Neer's criteria.
- Significant improvement in pain scores (mean 2.9 to 0.6) and active flexion (70° to 120°).
- Active external rotation improved, and no postoperative instability was observed.
Conclusions:
- Neer humeral hemiarthroplasty provides significant pain relief and functional improvement in patients with combined glenohumeral arthritis and irreparable rotator cuff tears.
- Despite being inferior to outcomes in patients with intact rotator cuffs, it is a valuable alternative to arthrodesis, resection, or constrained arthroplasty.