Hemiarthroplasty and total shoulder arthroplasty for avascular necrosis of the humeral head

Brian T. Feeley, Stephen Fealy, David M. Dines, Russell F. Warren, Edward V. Craig

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

The purpose of this study was to review the outcome of patients with osteonecrosis of the humeral head, based on etiology and treatment with either hemiarthroplasty or total shoulder arthroplasty (TSA). Sixty-four shoulders, with an average age of 57 years, were evaluated at a mean of 4.8 years. Outcomes included L'Insalata and American Shoulder and Elbow Surgeons (ASES) scores, as well as range of motion (ROM). The overall ASES score was 67, average flexion was 127°, and external rotation was 49°. Outcomes did not differ based on etiology, but ROM was decreased with post-traumatic osteonecrosis. There was no difference in outcome or ROM between hemiarthroplasty and TSA. The complication rate was significantly higher with TSA (22%) than with hemiarthroplasty (8%). Achieving ROM in patients with post-traumatic osteonecrosis remains difficult. TSA was associated with a higher complication rate and decreased mobility and should be reserved for patients with stage V osteonecrosis.

Original languageEnglish (US)
Pages (from-to)689-694
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Volume17
Issue number5
DOIs
StatePublished - Sep 2008

Bibliographical note

Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.

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