Arthrosurface Shoulder HemiCAP in Orthopaedic Insights

Arthrosurface shoulder HemiCAP products were recently featured in an Orthopaedic Insights article, a physician newsletter published by the Cleveland Clinic. We are very pleased with the patient results and are excited to share this article with our followers.

Article excerpt:

“Partial cap resurfacing of humeral bone defects has been used specifically in the setting of shoulder instability for nearly five years at Cleveland Clinic. Our indications for the device include the following:

  • A humeral head lesion of at least 25 percent of the total area of the articulating surface
  • An engaging Hill-Sachs or reverse Hill-Sachs lesion
  • Continued shoulder instability despite previous arthroscopic treatment of soft-tissue structures

Shoulders with deficient glenoid bone stock also undergo a Latarjet procedure at the same time as humeral defect resurfacing (Figure 2). All operations are performed through a deltopectoral approach, except for one case in which a muscle-splitting technique was used.

Our investigations are ongoing, but results thus far are very encouraging. To date, 21 shoulders in 20 patients (mean age, 34 years; range, 17 to 72 years) have been evaluated, with a mean follow-up of 28.1 months (range, 6 to 56 months). Sixteen of the 21 shoulders have undergone partial cap placement for a Hill-Sachs lesion in anterior shoulder instability, and five have undergone a partial cap placement to treat a reverse Hill-Sachs lesion.

None of the 21 shoulders has suffered a dislocation following HemiCAP implantation. Review of patient-reported outcome scores from both the Short-Form Health Survey (SF-12) and the Musculoskeletal Review of Systems reveals statistical improvement following surgery, and more than 80 percent of patients report a return to activity levels comparable to those before their shoulder injuries. Although these are relatively generic outcomes scores, improvement on these measures indicates overall patient improvement and increased quality of life. All patients undergoing shoulder surgery at Cleveland Clinic now also complete the shoulder-specific Penn Shoulder Score, with preliminary results in our patients showing a similar trend in improvement postoperatively.

Although recurrent glenohumeral instability remains a difficult problem to treat successfully, partial resurfacing arthroplasty of focal defects appears to be a promising technique for managing humeral bone loss.”

shoulder implant surgery
“Intraoperative photograph of a partial cap resurfacing
implant used for treatment of a Hill-Sachs lesion.”
shoulder joint pain
“Postoperative radiograph of a patient with recurrent shoulder instability treated with a combined Latarjet procedure and a partial cap resurfacing implant for a Hill-Sachs defect.”

-Orthopaedic Insights, Cleveland Clinic, Fall 2012

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