Long-term results and patient satisfaction after shoulder resurfacing

Background: Shoulder resurfacing has regained popularity in recent years. This report presents the long-term (> 20 years) results of this procedure with regard to patient satisfaction and implant survival. Materials and methods: We followed up 61 patients who underwent shoulder resurfacing procedures (74 shoulders) for a minimum of 20 years or until death (7 additional patients were lost to follow-up). The mean patient age at the time of surgery was 58 years. There were 41 total resurfacing procedures and 33 hemi-resurfacing procedures. The humeral component consisted of a cup with a short central peg that was placed either with or without cement. The glenoid was resurfaced with a cemented polyethylene or polyurethane component. Results: Patient satisfaction was 95%, and the survivorship of the humeral prostheses was 96%. There were no periprosthetic fractures, dislocations, or infections. Two humeral components were revised to stemmed prostheses (one for loosening and one for unexplained pain), and one was revised from a cementless to a cemented resurfacing prosthesis. Twelve cemented polyethylene glenoid prostheses had radiolucencies, but only three produced symptoms requiring revision surgery; three polyurethane glenoid prostheses showed severe wear radiographically, but none was loose or required revision surgery. There were 7 revision procedures, 6 with good results. Conclusions: Shoulder resurfacing is a successful procedure for the majority of patients, with high rates of patient satisfaction, long-term survivorship of the humeral prosthesis, and few complications. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.