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Humeral Head Resurfacing in a Weightlifter

March 01, 2020

Contributors: Christopher S Ahmad, MD, FAAOS; Matthew Joseph James Anderson, MD; Andrew John Luzzi, MD; John Mueller, MD; Rami Alrabaa

The management of symptomatic glenohumeral osteoarthritis in a young, active patient is a unique challenge orthopaedic surgeons. In patients in whom nonsurgical treatment fails, several surgical treatment options, ranging from arthroscopic débridement to total shoulder arthroplasty (TSA), are available. Although TSA is the preferred treatment option for elderly patients with advanced glenohumeral osteoarthritis, the rate of complications associated with TSA in young patients, who require greater implant longevity and durability, is substantially higher. Specifically, young patients who undergo TSA have an increased risk for glenoid component loosening. Originally developed in the 1980s, humeral head resurfacing has received renewed attention as an alternative to TSA in young patients with glenohumeral osteoarthritis who have a concentric glenoid and are unwilling to modify their activity level. Humeral head resurfacing eliminates the risk for glenoid component loosening, affords pain relief, and preserves adequate bone stock, allowing for revision to TSA, if necessary. This video demonstrates humeral head resurfacing in a bodybuilder with glenohumeral osteoarthritis in whom nonsurgical treatment and arthroscopic débridement failed and who was unwilling to undergo activity modifications. An emphasis was placed on soft-tissue balancing to restore anatomic glenohumeral motion and prevent eccentric glenoid wear. Patient presentation, physical examination, imaging studies, technical aspects of the procedure, and a review of the literature are discussed.

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