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Five-Year Radiographic and Clinical Outcomes of Pyrocarbon Hemiarthroplasty for Glenohumeral Arthritis and Osteonecrosis #MMPMID41231915
Griswold BG; Berger JM; Davis BP; Mauter L; Boyd M; Schuette HB; Johnston PS; Sears BW; Hatzidakis AM
J Bone Joint Surg Am 2025[Nov]; ? (?): ? PMID41231915show ga
BACKGROUND: This study evaluated the progression of humeral head medialization in patients who underwent pyrocarbon hemiarthroplasty (PyC-HA). The authors hypothesized that glenoid erosion would not dramatically progress between the short-term and final imaging evaluations, and that there would be excellent clinical outcomes at >/=5-year follow-up. METHODS: Patients who underwent PyC-HA with >/=60 months of follow-up were included in this prospective study. Relevant data included preoperative demographic characteristics, Walch glenoid classification, changes in clinical outcomes, and revision-free and failure-free survival rates. An investigator, who was blinded to patient outcomes, assessed the glenoid morphology, changes in medialization, joint space, acromiohumeral distance (AHD), critical shoulder and beta angles, and posterior subluxation in decentered glenoids at the 2-year and final follow-up visits. RESULTS: Forty-five patients with a mean age of 52 years and a mean follow-up of 73 months met the inclusion criteria. Significant improvements were observed across all outcome measures. The 7-year revision-free survival rate was 95.7%. Posterior subluxation in decentered shoulders decreased from 27.1% preoperatively to 19.8% postoperatively (p = 0.008). The mean medialization of the humeral head was 2.9 +/- 2.8 mm at the 2-year follow-up and increased to 4.0 +/- 3.3 mm at the time of the final follow-up (p = 0.096). A >2-mm decrease in AHD from early postoperative to final imaging was observed in 82.2% of patients (p < 0.001). All other radiographic changes were not significant. CONCLUSIONS: PyC-HA is a reliable procedure for treating glenohumeral joint disease, demonstrating excellent clinical outcomes and stabilized glenoid morphology in the majority of patients between the 2-year and intermediate-term follow-up. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
J+Bone+Joint+Surg+Am 2025 ; ? (?): ?
