Shoulder - Existing Treatments

Marrow Stimulation Techniques

Abrasion arthroplasty
In abrasion arthroplasty, a high-speed rotary burr or shaving device is used to remove about 1mm of bone from the surface of the lesion. This creates an exposed bone bed that will bleed and this will initiate a fibro-cartilage healing response. The fibro-cartilage then grows into and fills the hole or lesion creating a new but inferior surface. This technique can provide short-term (1-3 years) pain relief, but often patients are unable to resume their desired activity levels.

Microfacture/Microdrilling Technique
This technique is very similar to abrasion arthroplasty except that the bleeding is initiated by impacting awls, picks or drilling directly into the bone within the lesion. This procedure is more commonly performed in the knee.

HemiCAP^® Shoulder Resurfacing

Hemiarthroplasty is the replacement of only one articular surface of a joint, usually the ball or convex side, which means only a small amount of diseased tissue is being removed. If the opposite side of the shoulder joint (glenoid) is dmaged then that is referred to as a Total Shoulder resurfacing.  Arthrosurface offers a Glenoid implant that is unique due to the fact it sits "within" the bone and has a shape matched to your individual anatomy.  It is important to note that joint resurfacing removes less bone and soft tissue than a shoulder replacement.

The HemiCAP implant is a rounded, cap-like implant made from a cobalt chrome alloy with a central post on the implanted, or bone side. Cobalt chrome is a material that has been used in total joint reconstruction devices for over two decades. This has proven to provide a safe, effective and strong weight-bearing surface in joints. The HemiCAP system precisely aligns the surface of the implant to the contours of the patient's articular cartilage surface, thus filling the defect and restores a smooth and continuous articulating surface.

Arthrosurface believes that the HemiCAP implant will offer the following clinical advantages:

• Relief from current pain and swelling
• Return to normal activity with rapid recovery time
• Restoration of a smooth, continuous, articulating load-bearing surface.
• A simple and reproducible outpatient/ambulatory surgical procedure

Total Shoulder Replacement

The shoulder was the first human joint to be replaced with a prosthesis. The modern era of shoulder replacement dawns with the pioneering work of Dr. Charles S. Neer II. In 1953, he devised a hemiarthroplasty prosthesis for fractures of the humeral neck. Since then a number of designs emerged in both Europe and the United States to address the problem of the absent rotator cuff. Most were subsequently abandoned as these prostheses had a similar fate, usually due to loosening. The disappointing results of these designs led to a generally held view of the lack of success of shoulder replacement and rekindled an interest in alternative methods of treatment. An enormous number of designs, sometimes radically different, have appeared such as bipolar prostheses, surface replacements, components made from other biomaterials and most recently modular components. A key factor in any design is the importance of recreating the anatomy. The anatomy of the proximal humerus is complex. Designs to recreate this anatomy have been developed along with an alternative solution, which is the surface replacement.