Shoulder resurfacing is a bone-conserving arthroplasty that replaces only the damaged articular surface of the humeral head with a metal cap, preserving the humeral bone stock. It is an alternative to stemmed total shoulder replacement for younger patients.
An incision is made over the front of the shoulder. The humeral head is exposed and reshaped. A metal resurfacing cap is cemented onto the prepared humeral head, covering the damaged cartilage surface. The glenoid may be left unresurfaced (hemiarthroplasty) or replaced with a polyethylene component. No humeral canal reaming or stem insertion is needed. The operation takes one to one and a half hours.
Resurfacing is considered for younger patients (under 55-60) with glenohumeral arthritis who wish to preserve humeral bone stock for potential future revision, patients with humeral deformity making stemmed implants difficult, and AVN of the humeral head with intact glenoid.
Physiotherapy, injection, activity modification. Stemmed total shoulder replacement, hemiarthroplasty, and biological resurfacing are surgical alternatives.
X-rays and CT to assess humeral head shape and glenoid wear. MRI to assess rotator cuff integrity — an intact cuff is essential.
Pain relief and restoration of movement while preserving humeral bone stock. If revision is needed later, conversion to a stemmed replacement is straightforward.
If the glenoid is not replaced, the metal cap may wear into the native glenoid.
Not all patients achieve complete pain relief.
Temporary.
If AVN progresses under the cap.
The cap may loosen from the humeral head.
Humeral neck fracture during or after surgery.
Prosthetic joint infection.
Cuff damage during surgery.
General anaesthesia with nerve block.
Sling for two to four weeks. Gentle exercises from day one. Active movement from two to four weeks. Strengthening from six weeks. Full recovery three to six months.
X-rays at six weeks, three months, one year, then annually.
Younger patients may need revision surgery decades later. Preserving the humeral bone stock makes future revision to a stemmed implant much simpler.