To The Editor:
I read with great interest the follow-up of hemiarthroplasty of the
shoulder in osteoarthritis by Wirth, et al(1). The function and survivorship in these patients
certainly emphasises that hemiarthroplasty is an adequate procedure for
osteoarthritis in selected patients.
The authors have defined adequate soft tissue release and explained
their method for choosing a center point for the glenoid even in the
presence of erosion, which is very useful information for shoulder arthroplasty
surgeons.
It was interesting to read that the results in this series did not
seem to be affected by the presence of rotator cuff tears. The subgroup of
patients who had a nonconcentric glenoid and persistent luxations seemed to
have a worse functional score. We would be keen to know if this group had
a higher rate of glenoid erosion on follow-up as might be expected.
It was interesting to note that the subscapularis deficiencies
were a result of muscle atrophy even though there was no direct damage to the muscle as the lesser tuberosity was
osteotomised and presumably healed uneventfully. Assuming that the
possibility of damage to the nerve supply of the subscapularis was unlikely, I would pose the question of what was the reason for subscapularis atrophy?
Reference:
1. Wirth MA, Tapscott RS, Southworth C, Rockwood CA. Treatment of glenohumeral arthritis with a hemiarthroplasty: a minimum five-year follow-up outcome study. J Bone Joint Surg Am. 2006; 964-973.
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