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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(01): 091-097
DOI: 10.1055/s-0039-3402471
Artigo Original
Ombro e Cotovelo

Humeral Head Osteonecrosis: Outcomes of Hemiarthroplasty After Minimum 10-Year Follow-Up[*]

Article in several languages: português | English
Alberto Naoki Miyazaki
1   Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Grupo de Cirurgia de Ombro e Cotovelo, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Guilherme do Val Sella
2   Grupo de Cirurgia de Ombro e Cotovelo, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Luciana Andrade da Silva 
2   Grupo de Cirurgia de Ombro e Cotovelo, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Caio Santos Checchia
2   Grupo de Cirurgia de Ombro e Cotovelo, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Felipe Cerávolo Lemos
2   Grupo de Cirurgia de Ombro e Cotovelo, Santa Casa de São Paulo, São Paulo, SP, Brasil
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Abstract

Objective To analyze long-term functional and radiographic results of partial shoulder replacement for humeral head osteonecrosis.

Methods Retrospective review of thirteen cases, with a mean postoperative follow-up of 17 years (range 10 to 26 years). The findings from the last follow-up were compared to those in which the patients had one year of postoperative follow-up. Functional assessment consisted of shoulder movement measurements and application of the University of California, Los Angeles (UCLA) shoulder score. All patients underwent radiographic examination to measure glenoid erosion, proximal humeral migration and lateral glenohumeral dislocation.

Results Glenoid erosion increased over time significantly (p < 0.05). Paradoxically, all active shoulder movements also improved (p < 0.05), while UCLA scores remained the same. Radiographic deterioration was not correlated with clinical function. We had an 84.7% survival rate for arthroplasties after a mean time of 16 years.

Conclusions Early functional outcomes were maintained in the long run and do not correlate with radiographic deterioration (increased erosion of the glenoid).

Keywords

osteonecrosis - humeral head - follow-up studies

* Shoulder and Elbow Surgery Group, Department of Orthopedics and Traumatology, Faculty of Medical Sciences of Santa Casa de São Paulo,“Pavilhão Fernandinho Simonsen” (DOT – FCMSCSP) (Director: Prof. Ivan Chakkour, Ph.D).




Publication History

Received: 21 June 2019

Accepted: 03 October 2019

Article published online:
16 March 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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