gms | German Medical Science

Objective: The purpose of this study is to evaluate a consecutive series of proximally porous-coated hemi-arthroplasty for the treatment of severe proximal humeral fractures with special emphasis on aseptic loosening and functional outcome.

Methods: All consecutive patients (N=30) treated with porous-coated hemi-arthroplasty for severe fractures of the proximal humerus were observationally followed for an average of 37 months (13 to 62 months). All hemi-arthroplasties were of a single proximally porous coated, uncemented design. We evaluated clinical and radiological aseptic loosening, Constant Score, Patient satisfaction and VAS-score, Range of Motion, radiological parameters such as head-to-tuberosity distance, lateral projection and lateral offset.

Results and conclusions: The overall Constant Score was 68 SD 18, the mean patient satisfaction 7.1 SD 1.8 and the average VAS-score 3.7 SD 2.5. We observed no cases of radiographic tilting or subsidence. In 17 cases (57%) small radiolucent lines of 1.0mm or less were observed in fewer than 3 zones. None of the cases met the criteria for radiographic loosening. No revision was performed for aseptic loosening. The average HTD was 7.6 SD 8.7 mm. We found that traumatic neurological deficit and HTD significantly influenced Constant Score. Lateral projection significantly correlated with Constant Score, active forward flexion and abduction.

Proximally porous-coated hemi-arthroplasty is a valuable alternative alongside cemented hemi-arthroplasty for the treatment of severe fractures of the proximal humerus. Lateral projection is associated with range-of-motion.