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SHORT-TERM RESULTS OF COPELAND SHOULDER HEMI-ARTHROPLASTY



Abstract

Introduction: The Copeland Shoulder prosthesis was developed as an alternative to the more traditional prostheses. This cementless design differs in that it resurfaces, rather than replaces, the native humeral head. The obvious advantage of this design is only a minimum of bone is removed thus preserving bone stock for future revisions if needed. There exists little in the orthopaedic literature concerning the clinical results of patients with a Copeland shoulder prosthesis.

Materials and methods: Twenty-four patients receiving a Copeland hemiarthroplasty were identified at our institution between 1997 and 1999. All operations were performed by the senior author. A minimum of one-year follow-up was essential. Nineteen patients with twenty shoulders were available for follow-up at a mean of 2.2 years. Patients’ charts and operative reports were examined, and patients’ received retrospective pre-operative and prospective post-operative application of the constant score. AP and axillary lateral radiographs were examined for component position, evidence of osteolysis, and glenoid wear.

Results: The average Constant scores showed improvement in all subgroups: pain relief increased from 0.4 pre-operatively to 8.4 post-operatively; function rose from 9.3 to 14.3; and range of motion from 14.4 to 29.3. Two of twenty components required revision: one for loosening and the other for head collapse. One prosthesis showed some evidence of osteolysis, and five glenoids showed evidence of further wear.

Conclusion: Copeland hemiarthroplasty of the shoulder is effective in providing improved pain relief and function in short-term follow-up. The ability to preserve bone stock for future procedures may be ideal especially for the young, active patient. Complications are similar to those seen in more traditional hemiarthroplasties—loosening, osteolysis, and progressive glenoid wear. The 10% revision rate is slightly higher than reported in most total shoulder and hemiarthroplasty series. Longer follow-up will be essential to make any definitive conclusions.

The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.