Functional and radiographic long-term outcomes of hemiarthroplasty for proximal humeral fractures

Matthew P. Noyes, Benjamin Kleinhenz, Ronald J. Markert, Lynn A Crosby

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Hemiarthroplasty is the preferred surgical procedure for 3- and 4-part proximal humeral fractures. Our retrospective study examined functional and radiographic outcomes at 2- and 5-year follow-up in patients who received a hemiarthroplasty for 3- and 4-part proximal humeral fractures. Materials and methods: Forty-seven consecutive patients of a single surgeon treated with a cemented shoulder hemiarthroplasty between 2000 and 2006 were followed up. Standard surgical technique was used in all cases. Postoperative radiographs were compared with radiographs at 2 and 5 years along with active range of motion and functional outcomes scores. Results: Twenty-five patients were examined at 2 years and twenty-two at 2 and 5 years. The mean age was 61 years. The mean acromiohumeral distance decreased from 10.3 mm postoperatively to 8.5 mm at 2 years and 6.7 mm at 5 years (P ≤ .001). More patients had stem osteolysis and tuberosity reabsorption at 2 and 5 years compared with postoperatively (P = .016 and P ≤ .001, respectively). The University of California, Los Angeles score decreased from 26.0 to 22.3 (P = .045); the Constant score decreased from 61.1 to 50.1 (P = .01); the Simple Shoulder Test 12 score decreased from 7.7 to 6.2 (P = .018); and the American Shoulder and Elbow Surgeons score decreased from 70.4 to 58.8 (P = .015). Pain scores increased from 2- to 5-year follow-up (P = .018). The range-of-motion measures changed little from the 2-to 5-year follow-up. Conclusions: Hemiarthroplasty has a high rate of long-term complications. Increases in acromiohumeral distance, stem osteolysis, and tuberosity reabsorption were observed between 2- and 5-year follow-up. Pain scores and functional outcomes worsened. No improvement in range of motion was observed.

Original languageEnglish (US)
Pages (from-to)372-377
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Volume20
Issue number3
DOIs
StatePublished - Mar 1 2011

Fingerprint

Shoulder Fractures
Hemiarthroplasty
Articular Range of Motion
Osteolysis
Pain
Los Angeles
Elbow
Retrospective Studies
Surgeons

Keywords

  • Case Series
  • Fracture
  • Hemiarthroplasty
  • Level IV
  • Outcomes
  • Proximal humerus
  • Radiographs
  • Treatment Study

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Functional and radiographic long-term outcomes of hemiarthroplasty for proximal humeral fractures. / Noyes, Matthew P.; Kleinhenz, Benjamin; Markert, Ronald J.; Crosby, Lynn A.

In: Journal of Shoulder and Elbow Surgery, Vol. 20, No. 3, 01.03.2011, p. 372-377.

Research output: Contribution to journalArticle

Noyes, Matthew P. ; Kleinhenz, Benjamin ; Markert, Ronald J. ; Crosby, Lynn A. / Functional and radiographic long-term outcomes of hemiarthroplasty for proximal humeral fractures. In: Journal of Shoulder and Elbow Surgery. 2011 ; Vol. 20, No. 3. pp. 372-377.
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AB - Background: Hemiarthroplasty is the preferred surgical procedure for 3- and 4-part proximal humeral fractures. Our retrospective study examined functional and radiographic outcomes at 2- and 5-year follow-up in patients who received a hemiarthroplasty for 3- and 4-part proximal humeral fractures. Materials and methods: Forty-seven consecutive patients of a single surgeon treated with a cemented shoulder hemiarthroplasty between 2000 and 2006 were followed up. Standard surgical technique was used in all cases. Postoperative radiographs were compared with radiographs at 2 and 5 years along with active range of motion and functional outcomes scores. Results: Twenty-five patients were examined at 2 years and twenty-two at 2 and 5 years. The mean age was 61 years. The mean acromiohumeral distance decreased from 10.3 mm postoperatively to 8.5 mm at 2 years and 6.7 mm at 5 years (P ≤ .001). More patients had stem osteolysis and tuberosity reabsorption at 2 and 5 years compared with postoperatively (P = .016 and P ≤ .001, respectively). The University of California, Los Angeles score decreased from 26.0 to 22.3 (P = .045); the Constant score decreased from 61.1 to 50.1 (P = .01); the Simple Shoulder Test 12 score decreased from 7.7 to 6.2 (P = .018); and the American Shoulder and Elbow Surgeons score decreased from 70.4 to 58.8 (P = .015). Pain scores increased from 2- to 5-year follow-up (P = .018). The range-of-motion measures changed little from the 2-to 5-year follow-up. Conclusions: Hemiarthroplasty has a high rate of long-term complications. Increases in acromiohumeral distance, stem osteolysis, and tuberosity reabsorption were observed between 2- and 5-year follow-up. Pain scores and functional outcomes worsened. No improvement in range of motion was observed.

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KW - Treatment Study

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