Surface Arthroplasty for Treating Primary and/or Secondary Shoulder Osteoarthrosis by Means of the Hemicap-Arthrosurface® System

Abstract

Objective: To present the surgical technique for the He-miCAP-Arthrosurface® system and evaluate our results from this technique for treating primary and/or secondary shoulder osteoarthrosis. Method: Between June 2007 and June 2009, 10 shoulders of 10 patients (nine with primary osteoarthrosis and one with avascular necrosis of the humeral head) underwent surface arthroplasty using the HemiCAP-Arthrosurface® system to correct the problem. The follow-up time ranged from six to 29 months (mean of 17 months). The patients’ ages ranged from 62 to 73 years (mean of 67.5 years). Six patients were female and four patients were male. The patients were followed up weekly for the first month after the surgical procedure and every three months thereafter. The clinic evaluation was done using the criteria of the University of California at Los Angeles (UCLA) and a visual analogue pain scale. Results: All the patients said that they were satisfied with the results from the surgical treatment, with a mean UCLA score of 30 points and a mean analogue pain score of two points. Conclusion: The HemiCAP-Arthrosurface® system for shoulder surgery for a specific group of patients is a technique that preserves the bone stock with good functional and antalgic results.

The histopathology of the humeral head in glenohumeral osteoarthritis

“…Therefore the possibility exists in the shoulder that maintaining range of motion is important for preserving humeral head cartilage health, a notion supported by a number of arthroscopic studies that manage GOA by restoring range of motion [ 23 , 25 , [49] , [50] , [51] , [52] , [53] ] because in early GOA, joint stiffness is a bigger complaint than pain [ 25 ]. The use of capsular release as a critical part of treatment of early osteoarthritis in conjunction with partial biologic or prosthetic resurfacing [ [54] , [55] , [56] , [57] , [58] , [59] ] also supports the critical role for a critical interaction between preserving range of motion and joint health. The predominance of joint stiffness rather than pain in early GOA is also consistent with our results here, in which, in contrast to the many associations of humeral head pathology with range of motion, pre-operative pain was associated only with cartilage and subchondral bone plate thinning in the periphery of anterior-inferior humeral head, and not with any outcome measure associated with cartilage pathology.…”

The role of the anterior shoulder joint capsule in primary glenohumeral osteoarthritis

“…These findings lead one to consider the potential link between maintaining range of motion and the preservation of humeral head cartilage, especially considering the early success of capsular release in conjunction with partial biologic or prosthetic resurfacing techniques for the treatment of early GHOA. 2 , 10 , 47 , 49 , 51

Figure 3 Central ( A ) and peripheral region ( B ) cartilage thickness and heat map ( C ). Central ( D ) and peripheral region ( E ) subchondral bone area and heat map ( F ).

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Metal Resurfacing Inlay Implant for Osteochondral Talar Defects After Failed Previous Surgery: A Midterm Prospective Follow-up Study

“…A metal resurfacing implant (HemiCAP; Arthrosurface Inc), used in the humeral and femoral heads and even adapted for metatarsal head resurfacing, has been introduced as a secondary treatment option for medial talar OCDs. 6,18,30,35 This implant has shown promising results in the resurfacing of large talar OCDs, with a 0% implant failure in 20 patients over a mean follow-up of 3 years. 30 However, the follow-up time of the previous study was short and the number of patients small.…”