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Long-term outcomes after humeral head replacement and total shoulder replacement for osteonecrosis of the humeral head: a mean follow-up of 8 years

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study was to compare the outcomes and complications after humeral head replacement (HHR) and total shoulder replacement (TSR) in patients with osteonecrosis of the humeral head (ONHH).

Materials and methods

Twenty-six patients who underwent shoulder replacement (13 HHRs and 13 TSRs) for nontraumatic ONHH were included. The mean follow-up period was 96.4 months. The visual analog scale (VAS) pain score, the University of California at Los Angeles (UCLA) score, the American Shoulder and Elbow Surgeon (ASES) score, and range of motion (ROM) at the final follow-up evaluation were used for the assessment of clinical outcomes.

Results

The mean VAS pain score, UCLA score, and ASES score showed significant improvement from 6.3, 11.6, and 35.0 before surgery to 2.2, 28.9, and 82.6 at the final follow-up evaluation (all p < 0.001). No significant differences regarding all clinical scores and ROMs were observed between the HHR group and the TSR group, except that a greater abduction angle was observed in the HHR group compared with the TSR group (123.1° versus 96.9°, p = 0.014). Two patients in the TSR group underwent multiple reoperations due to periprosthetic joint infection. No revision surgeries were performed for glenoid erosion following HHR or aseptic glenoid loosening following TSR.

Conclusions

The findings of this study showed satisfactory clinical and radiological outcomes with implant longevity for both HHR and TSR in patients with nontraumatic ONHH. The HHR group had a greater abduction angle compared with the TSR group.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Eun-Ji Jeon and Ye-Ji Kim for their support with data collection.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Seoul, South Korea

    Sung-Min Rhee

  2. Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubul-ro, Dalseo-gu, Daegu, 42601, South Korea

    Du-Han Kim & Chul-Hyun Cho

  3. Department of Orthopaedic Surgery, Myongji Hospital, Gyeonggi-Do, Goyang-Si, South Korea

    Yong Girl Rhee

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Contributions

S-MR performed data curation and writing—review and editing. D-HK did methodology and data curation. YGR done conceptualization, supervision. C-HC contributed to conceptualization and writing—original draft.

Corresponding author

Correspondence to Chul-Hyun Cho.

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The authors declare no competing interests.

Ethical approval

This study was approved by Keimyung University Dongsan Hospital Institutional Review Board (no. 202206028).

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1 and 2.

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Rhee, SM., Kim, DH., Rhee, Y.G. et al. Long-term outcomes after humeral head replacement and total shoulder replacement for osteonecrosis of the humeral head: a mean follow-up of 8 years. Arch Orthop Trauma Surg 143, 4597–4604 (2023). https://doi.org/10.1007/s00402-022-04724-7

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