Je Kyun Kim1, Hyeon Jang Jeong1, Sang-Jin Shin2, Jae Chul Yoo3, Tae-Yon Rhie4, Kyoung-Jin Park5, Joo Han Oh6. 1. Department of Orthopaedic Surgery Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. 2. Ewha Shoulder Disease Center, Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea. 3. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. Nalgae Hospital, Seoul, Republic of Korea. 5. Department of Orthopaedic Surgery, Chungbuk National University College of Medicine, Cheongju, Republic of Korea. 6. Department of Orthopaedic Surgery Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. Electronic address: ohjh1@snu.ac.kr.
Abstract
PURPOSE: To verify the clinical features and the risk factors of rapid progressive osteonecrosis of the humeral head after arthroscopic rotator cuff surgery (ARCS). METHODS: Data and medical records of 24 patients who had rapid progressive collapse of the humeral head after ARCS performed from October 2012 to March 2016 were retrospectively analyzed. Among them, 8 patients demonstrated no evidence of osteonecrosis of the humeral head preoperatively yet developed rapid progressive collapse of the humeral head within 12 months after ARCS. RESULTS: All patients were women with a mean age of 64.0 years (range, 52-74 years), and all of them had surgery on their dominant side. Sudden pain developed at a mean 4 months (range, 0-6 months) after index surgery. The rapid progressive collapse of the humeral head occurred within 12 months after index surgery. No clear risk factor or evidence supporting an association between ARCS and humeral head osteonecrosis was found. CONCLUSIONS: Although the cause of the rapid progressive humeral head osteonecrosis after ARCS still needs to be established, surgeons should be aware of the possible development of humeral head osteonecrosis after ARCS, especially in older women with dominant arm involvement. LEVEL OF EVIDENCE: Level IV, prognostic case series.
PURPOSE: To verify the clinical features and the risk factors of rapid progressive osteonecrosis of the humeral head after arthroscopic rotator cuff surgery (ARCS). METHODS: Data and medical records of 24 patients who had rapid progressive collapse of the humeral head after ARCS performed from October 2012 to March 2016 were retrospectively analyzed. Among them, 8 patients demonstrated no evidence of osteonecrosis of the humeral head preoperatively yet developed rapid progressive collapse of the humeral head within 12 months after ARCS. RESULTS: All patients were women with a mean age of 64.0 years (range, 52-74 years), and all of them had surgery on their dominant side. Sudden pain developed at a mean 4 months (range, 0-6 months) after index surgery. The rapid progressive collapse of the humeral head occurred within 12 months after index surgery. No clear risk factor or evidence supporting an association between ARCS and humeral head osteonecrosis was found. CONCLUSIONS: Although the cause of the rapid progressive humeral head osteonecrosis after ARCS still needs to be established, surgeons should be aware of the possible development of humeral head osteonecrosis after ARCS, especially in older women with dominant arm involvement. LEVEL OF EVIDENCE: Level IV, prognostic case series.