Is Shoulder Resurfacing Hemiarthroplasty Still a Valid Treatment for Younger Patients? 10-15 Year Patient follow-up Data for the Global Conservative Anatomic Prosthesis

Background:
Shoulder resurfacing hemiarthroplasty has largely fallen out of favour owing to high reported revision rates. We present 10-15 year follow up data for the Global Conservative Anatomical Prosthesis (C.A.P); the longest series published to date.

Methods:
Patients who underwent shoulder resurfacing hemiarthroplasty using the Global C.A.P between March 2005 and May 2010 were contacted via telephone. All operations were performed by a single surgeon. Patients were asked to rate their current pain and satisfaction on a 11-point numerical scale (0-10). Oxford shoulder scores (OSS) and Quick-DASH scores were also completed.

Results:
46 patients (49 resurfacings) were identified. 20 patients were deceased, 3 had been revised, 3 were uncontactable and 1 had developed dementia. Complete data was obtained for 19 patients (73% response rate). The mean respondent age at time of surgery was 68.8 years. 68% were female. The principal indication was osteoarthritis (74%). The mean pain score was 2.2 with a mean satisfaction score of 6.9. The mean OSS was 43.1 and mean Quick-DASH 14.1 indicating good shoulder function. When stratified according to age at time of surgery, younger patients (<65) were found to have higher OSS (p=0.036) and lower Quick-DASH scores (p=0.029) at follow up (Mann-Whitney U Test).

Conclusion:
At minimum 10 year follow up, patients who underwent shoulder resurfacing hemiarthroplasty had low pain scores, high satisfaction scores and good patient reported outcome measures. We propose that shoulder resurfacing hemiarthroplasty retains value, particularly for painful osteoarthritis in younger patients who do not wish to undergo total shoulder replacement. The operation is simple and preserves humeral bone stock for future surgery.