Two-Year Follow-Up of Shoulder Hemiarthroplasty with a Cta Head for Cuff-Tear Arthropathy

Background: Cuff tear arthropathy (CTA)-specific hemiarthroplasty was designed to allow for smoother articulation. Results following standard hemiarthroplasty for CTA have been unpredictable. Recent work emphasized the importance of closely evaluating cuff-deficient shoulders with histories, exams, and radiographs in an attempt to provide better treatment algorithms for these shoulders. We hypothesized that CTA-specific hemiarthroplasty for cuff-deficient shoulders without prior surgical intervention would improve shoulder comfort and function. Methods: From November 2006 to January 2009, we performed 22 CTA-specific hemiarthroplasties in 21 patients with previously unoperated shoulders. All were assessed with radiographs and scored according to Seebauer. Constant and Simple Shoulder Test scores were obtained pre-operatively and at a minimum two-year follow-up. Results: 15 of the original 22 shoulders were available for evaluation by an orthopaedist other than the operative surgeon. One was lost to follow-up. 3 were in patients that had died. Mean absolute Constant score improved from 37 pre-op to 62 post-op; mean Simple Shoulder Test score improved from 4 to 9. Of the 15, there were 2 IA's, 0 IB's, 13 IIA's, and 0 IIB's according to Seebauer's classification. 4 out of 22 (18%) shoulders were either converted to reverse arthroplasties (2) or were in patients that were dissatisfied with their results and refused follow-up (1) or lost to follow-up (1). Conclusions: CTA-specific hemiarthroplasty for rotator cuff-deficient shoulders with arthritis and without escape or previous surgery improves comfort and function in most shoulders. However, the risk of conversion to reverse, dissatisfaction, or presumed dissatisfaction in this small series was 18% in short term follow-up.