HEMIARTHROPLASTY OF THE SHOULDER FOR ROTATOR CUFF ARTHROPATHY

Sixteen patients underwent hemiarthroplasty for rotator cuff arthropat hy between June 1989 and March 1992, and evaluations obtained before a nd after surgery in all patients were compared. A modular head large e nough to articulate with the coracoacromial arch but not so large as t o prevent approximately 50% of humeral head translation on the glenoid was used in these cases. Each patient was evaluated with Neer's limit ed goals rating scale after an average follow-up of 33 months (24 to 5 5 months). Ten patients were rated as successful and six as unsuccessf ul. Four of the six unsuccessful patients had undergone at least one a ttempt at rotator cuff repair with acromioplasty before the index proc edure, and two of these four patients had deficient deltoid Function a fter this rotator cuff surgery as a result of postoperative deltoid de tachment. Also, three of these four patients who had previously underg one acromioplasty subsequently had anterosuperior subluxation after he miarthroplasty. Hemiarthroplasty did not provide For a successful outc ome in all patients with rotator cuff arthropathy. However, 10 of the 12 patients in this series with good deltoid function and an adequate coracoacromial arch were rated as successful by Neer's limited goals c riteria. In addition, this study illustrates that Formal acromioplasty carried out during attempts at rotator cuff repair in such patients m ay jeopardize the subsequent success of hemiarthroplasty.