Arthrosurface Resurfacing Shoulder Replacement
Standard Total Shoulder Replacement performed for arthritis of the shoulder is a highly successful operation. There are , however, reasons to believe that an alternative type of replacement is more appropriate for more active individuals, younger individuals, and Laboring Workers who will put significant stress on the implant.
Dr. Goding uses the Arthrosurface Ovo system which he believes is the best implant for these high activity patients. The reasons for this belief are founded in the unique design elements of the system. The humeral head is preserved rather than cut off. This in and of itself is a significant advantage over standard or even stemless humeral head implants, both of which remove significantly more bone than than the Ovo system.
Standard Total Shoulder Replacement:
Humeral head (ball of shoulder joint) is removed.
Onlay Glenoid (socket of shoulder joint) is used.
Humeral head preserved
Rim of bone preserved around Glenoid component.
The advantage of maintaining the humeral head include having significantly more bone to work with if the implant fails decades down the road and revision surgery is necessary. The screw in fixation method of the head resurfacing has also been shown to be more stable than standard press fit stemmed shoulder implants.
On the glenoid side, the differences are even greater , and Dr. Goding truly believes that the inlay Glenoid is truly a game changer for patients. By maintaining a rim of bone around the implant, rather than completely covering the Glenoid the implant has tested to be 10 x more stable than any onlay type of glenoid. Edge loading is the most common reason for failure in Total Shoulder Replacement. The inlay Glenoid preserves a rim of bone around the implant.
Biomechanical laboratory testing has shown that all tested onlay type glenoids failed at 700-1100 loaded cycles when placed on a machine designed to simulate shoulder motion. The inlay glenoid was still intact at 4000 cycles, the predetermined endpoint of the experiment.
Patients have been able to return to athletics, heavy labor and even powerlifting after having the Arthrosurface shoulder resurfacing. Many surgeons are not able to perform this procedure due to its difficulty. Dr. Goding actively teaches this technique to other surgeons around the country in organized courses in major cities. Dr. Goding strongly believes that this is the best implant for younger, active individuals with shoulder arthritis.
Gagliano JR, Helms SM, Colbath GP, Przestrzelski BT, Hawkins RJ, DesJardins JD.
J Shoulder Elbow Surg. 2017 Jul;26(7):1113-1120. doi: 10.1016/j.jse.2017.01.018. Epub 2017 Mar 27.