Radiological Analysis of Proximal Humerus Restoration and Functional Outcome in Shoulder Hemiarthroplasty

Abstract

In shoulder hemiarthroplasty, the glenohumeral offset, subacromial gap, vertical and horizontal measurements of tuberosities, and stage of fatty infiltration are some of the radiological parameters that evaluate the restoration of proximal humerus. This study was designed to determine which radiological parameters are more compatible with functional results after hemiarthroplasty. Twenty-five patients, who were treated between 2002 and 2010 for proximal humerus fractures with hemiarthroplasty and had post-operative computed tomography (CT) scans, were evaluated. The final position of the prosthetic head, tuberculum restoration, and fatty degeneration of the supraspinatus muscle were analysed radiologically. The American Shoulder and Elbow Society (ASES) score, Constant–Murley score, Disabilities of the Arm, Shoulder, and Hand (DASH) index score were used to determine functional performance. The mean ASES, Constant–Murley, and DASH index scores of patients aged 52 to 84 years were 70, 66, and 23, respectively. The patient group with a normal retroverted prothesis had higher Constant–Murley and lower DASH index scores (p<0.05). The group with 0 to 5 mm horizontal malpositioning in CT scans had better clinical outcomes (p<0.05). Better clinical outcomes were noted in the stage 0 fatty infiltration group (p<0.05). Hemiarthroplasty remains an important treatment option in proximal humerus fractures. In collaboration with achieving closer restoration to proximal humerus anatomy, the stage of fatty degeneration plays an important role in a successful functional result.Keywords: