Allograft glenoid resurfacing with humeral hemiarthroplasty yielded early failure rates
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Published results showed osteochondral allograft glenoid resurfacing combined with humeral hemiarthroplasty yielded early failure rates among patients with glenohumeral osteoarthritis.
“We investigated the results of glenoid allograft resurfacing combined with a prosthetic humeral head replacement on the basis of positive in-vitro results and because the currently preferred options [hemiarthroplasty] and [total shoulder arthroplasty] are not yet considered a safe and durable solution,” Filippo Familiari, MD, MBBS, told Healio. “However, we conclude that the technically feasible glenoid allograft for resurfacing of a degenerated glenoid surface combined with anatomical [hemiarthroplasty] does not work in-vivo. Thus, glenoid allograft resurfacing with prosthetic humeral head replacement is not a viable alternative for the treatment of advanced OA in the young individual due to its high risk of failure.”
Familiari and colleagues reviewed subjective shoulder value and relative Constant-Murley scores among five patients who underwent hemiarthroplasty with an osteochondral glenoid allograft for treatment of glenohumeral OA between April 2011 and November 2013. Researchers also reviewed standardized imaging preoperatively and at final follow-up or before revision surgery.
Results showed one excellent, one satisfactory and three poor clinical results, with revision occurring within the first 3 years among the patients with poor results. Researchers found patients had a mean preoperative subjective shoulder value of 34% and a preoperative relative Constant-Murley score of 43 points. Patients who underwent revision had a mean subjective shoulder value of 38% prior to revision and a relative Constant-Murley score of 36 points, according to results. Researchers noted one patient underwent revision 9 years after the primary procedure for advanced glenoid erosion and pain, with a subjective shoulder value of 60% and a relative Constant-Murley score of 65 points. Results showed one patient had an ongoing satisfactory outcome without revision, with a subjective shoulder value of 83% and a relative Constant-Murley score of 91 points at 10 years after the primary procedure. Researchers noted patients had a mean follow-up of 7 years and a mean time to revision of 4 years.
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