Medium- to Long-Term Survivorship Analysis Following Copeland Resurfacing Hemiarthroplasty

TL;DR

This study evaluates the long-term success of a bone-preserving shoulder surgery called Copeland resurfacing hemiarthroplasty, finding it improves function but has a notable revision rate.

Contribution

The study provides the first detailed medium- to long-term survivorship analysis of Copeland resurfacing hemiarthroplasty in a single-surgeon cohort.

Findings

CRHA improved the Oxford Shoulder Score postoperatively, doubling from 16 to 32.

The projected survival rate at 10 years was 79%, with 18.8% of patients requiring revision surgery.

Higher revision rates were observed in patients with cuff tear arthropathy and rheumatoid arthritis.

Abstract

Background

Copeland resurfacing hemiarthroplasty (CRHA) was developed as a bone-preserving alternative to stemmed hemiarthroplasty, offering advantages such as preservation of native anatomy and quicker recovery. However, there is limited evidence regarding its long-term survivorship.

Objective

The objective of this study is to determine the medium- to long-term survival outcomes and functional results of CRHA performed in a single-surgeon series.

Methods

A retrospective cohort study was conducted on patients who underwent CRHA between 2007 and 2013 at King's Mill Hospital, Mansfield, UK. There were no inclusion or exclusion criteria; all patients had significant morbidity and radiological evidence of glenoid arthropathy (Walch classification). The Oxford Shoulder Score (OSS) was collected pre- and postoperatively. Kaplan-Meier survival analysis was performed. Statistical analysis was carried out using IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York, United States), with significance set at p<0.05.

Results

Eighty CRHAs were performed in 72 patients (eight bilateral procedures). The mean follow-up was 79 ± 18 months (range 50-122), corresponding to approximately 6.5 years. The primary indication was osteoarthritis (76.3%), followed by cuff tear arthropathy (CTA) (16.3%), rheumatoid arthritis (RA) (5%), and post-trauma (1.3%). The mean preoperative OSS was 16 ± 5, which doubled postoperatively to 32 ± 8 (p<0.05). Fifteen patients (18.8%) underwent revision surgery, with a mean time to revision of 49 ± 11 months. Projected survival at five, seven, and 10 years was 83%, 81%, and 79%, respectively.

Conclusion

CRHA improved pain and function in the medium term but demonstrated a higher revision rate compared with other arthroplasty options, particularly in patients with CTA and RA. These findings should guide patient selection and shared decision-making.

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