Long-term outcomes of hemiarthroplasty using a smaller head combined with rotator cuff reconstruction in patients with cuff-tear arthropathy

Chika Yoshioka; Naoki Suenaga; Naomi Oizumi; Shintaro Yamane; Yukiyoshi Hisada; Tomoya Matsuhashi; Naoki Miyoshi; Jun Kawamata

doi:10.1016/j.jseint.2023.12.006

Long-term outcomes of hemiarthroplasty using a smaller head combined with rotator cuff reconstruction in patients with cuff-tear arthropathy

JSES Int. 2024 Jan 18;8(3):638-645. doi: 10.1016/j.jseint.2023.12.006. eCollection 2024 May.

Authors

Chika Yoshioka¹, Naoki Suenaga¹, Naomi Oizumi¹, Shintaro Yamane¹, Yukiyoshi Hisada¹, Tomoya Matsuhashi¹, Naoki Miyoshi², Jun Kawamata³

Affiliations

¹ The Upper Extremity Center of Joint Replacement and Endoscopic Surgery, Hokushin Orthopaedic Hospital, Sapporo, Hokkaido, Japan.
² Department of Orthopaedic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
³ Department of Orthopedics, Tokushima University, Tokushima, Japan.

Abstract

Background: Hemiarthroplasty (HHR) using a smaller head with rotator cuff reconstruction is a treatment option for cuff-tear arthropathy, offering advantages like facilitating rotator cuff-tear closure, increasing the lever arm of deltoid, and restoring function in irreparable cuff tears. This study aimed to evaluate the long-term outcomes of this procedure.

Methods: A retrospective analysis was conducted for 91 shoulders undergoing HHR using a smaller head with rotator cuff reconstruction between May 2005 and September 2012. Surgery involved reducing the size of humeral head and performing rotator cuff reconstruction based on the site of the deficient rotator cuff. The study analyzed University of California, Los Angeles shoulder scores, Japanese Orthopaedics Association shoulder scores, range of motion, and postoperative radiographs.

Results: Twenty-eight patients, divided into an elderly group (14 women, 2 men, mean age 74.5 ± 3.8 years) and a younger group (6 women, 6 men, mean age 63.5 ± 3.1 years) were followed up for a mean of 133.2 ± 14.1 months. No complications were reported. The clinical scores and range of motion significantly improved postoperatively and remained over 10 years. Radiographs revealed high incidence of glenoid wear (82.1%), bone resorption (43%) and cranial humeral head migration (54%), with no prosthesis loosening.

Conclusion: We believe that HHR using a smaller head with rotator cuff reconstruction is a surgical technique that can maintain stable long-term outcomes in both elderly and younger individuals with cuff-tear arthropathy.

Keywords: Cuff-tear arthropathy; Glenoid wear; Hemiarthroplasty; Rotator cuff reconstruction; Smaller humeral head; Younger patients.