Functional outcome of shoulder hemiarthroplasty for fractures: A multicentre analysis

Abstract 

In this multicentre study, data on 102 shoulder hemiarthroplasties for the treatment of fractures were analysed retrospectively with regard to tuberosity healing and functional outcome.

Methods

Clinical outcome was assessed using the constant score (CS) and the American Shoulder and Elbow Score (ASES). The mean follow-up time was 28.1 months. The proportion of patients presenting tuberosity healing was 35.3% (36 out of 102).

Results

Anatomical tuberosity healing has a significant effect on CS, especially for lateral elevation (p=0.0076), forward elevation (p=0.0002), power (p=0.0023) and the ASES (p=0.017). However, the pain value of the CS was not influenced by tuberosity healing (p=0.34). In patients with anatomically healed tuberosities, the CS averaged 53.0 points, whereas in the group of patients with non-anatomical tuberosity healing, the score averaged 40.1 points (p=0.0004).

There was an 11-fold increase in tuberosity nonunion in females compared with males (p=0.0045). Further, nonunion was seen to be associated with advanced age of >70 years (p=0.037) and the presence of osteoporosis (p=0.034).

Conclusion

In this study, we found that anatomical tuberosity healing around the prosthesis improved functional outcome and range of motion.

Keywords: Shoulder, Proximal humerus, Fracture, Treatment, Prosthesis, Arthroplasty, Outcome, Complications, Tuberosity healing, Shoulder function