HUMERAL HEAD RESURFACING FOR ISOLATED PRIMARY HUMERAL OSTEOARTHRITIS WITH A LARGE CHONDRAL DEFECT
Figure 1 - Preoperative radiographs of the left shoulder. (A) Preoperative radiographs of the left shoulder in true anteroposterior of the glenohumeral joint (Grashey), (B) outlet view, and (C) axillary–lateral views. All 3 radiographic views are part of standard workup during initial evaluation of patients presenting with shoulder pain to assess for glenohumeral arthritis, acromioclavicular arthritis, dislocation, and fracture.
Primary, isolated humeral head arthritis or focal chondral defects are uncommon and difficult to diagnose preoperatively. While these lesions have traditionally been treated with total shoulder arthroplasty, shoulder hemiarthroplasty is a viable option for patients with isolated humeral head disease and minimal degenerative changes in the glenoid. This approach can be performed in a minimally invasive fashion, which preserves bone stock and native biomechanics, and can be beneficial if conversion to total shoulder arthroplasty is required in the future and avoids risk of glenoid loosening or failure in younger and more active individuals. In this Technical Note and accompanying video, we describe our technique of humeral head resurfacing in a patient with isolated primary humeral osteoarthritis with a large focal chondral defect in the humeral head.
Figure 2 - Arthroscopy photos of the left shoulder during index procedure. (A, B) Patient underwent previous arthroscopy due to biceps and acromioclavicular pathology and during the diagnostic arthroscopy a large chondral defect (16-18 mm) to the humeral head is found with no evidence of glenoid involvement.
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Published July 2022 in Arthroscopic Techniques.