Biologic resurfacing arthroplasty with acellular human
dermal allograft and platelet-rich plasma (PRP) in
young patients with glenohumeral arthritis—average
of 60 months of at mid-term follow-up
Eddie Y. Lo, MD
a,
*, Brody A. Flanagin, MD
b
, Wayne Z. Burkhead, MD
c
a
Center of Sports Medicine, St. Francis Memorial Hospital, San Francisco, CA, USA
b
The Shoulder Center at Baylor University Medical Center, Dallas, TX, USA
c
WB Carrell Memorial Clinic, Dallas, TX, USA
Background: The treatment of young patients with glenohumeral arthritis has been challenging. Alter-
native treatment options include activity modification, arthroscopic débridement, and arthroplasty. Addressing
the glenoid during arthroplasty in this population of patients continues to be a significant challenge. In
this study, we evaluated the midterm outcomes of hemiarthroplasty with biologic resurfacing of the glenoid
with human dermal matrix allograft.
Methods: Between 2004 and 2011, 55 patients underwent hemiarthroplasty and biologic resurfacing of
the glenoid with human dermal matrix allograft. The average age was 50 ± 9 years. Subjective evaluation
was performed with the Western Ontario Osteoarthritis of the Shoulder Index, American Shoulder and Elbow
Surgeons score, visual analog scale, and Single Assessment Numeric Evaluation. Patients returned to the
clinic for clinical examination and radiographic evaluation. The average follow-up was 60 months.
Results: The average postoperative American Shoulder and Elbow Surgeons score was 76 ± 22, and the
Western Ontario Osteoarthritis of the Shoulder Index score was 76% ± 22%. The visual analog scale score
was 2.4 ± 2.6. The average preoperative Single Assessment Numeric Evaluation score was 33% ± 22%,
which significantly improved to 72% ± 22% postoperatively. Eighty-one percent of the patients were sat-
isfied (10/47) or highly satisfied (28/47) with their result. With radiographic evaluation, the average joint
space was 1 ± 1 mm preoperatively and 2 ± 1 mm postoperatively. A total of 5 cases (9.1%) were revised
to anatomic total shoulder arthroplasty with implantation of a glenoid component.
Discussion: Hemiarthroplasty with biologic resurfacing of the glenoid using human dermal matrix al-
lograft can lead to successful midterm outcomes with satisfactory complication and revision rates. Both
patient satisfaction and clinical outcome remain high regardless of radiographic outcome.
Level of evidence: Level IV; Case Series; Treatment Study
© 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights
reserved.
Keywords: Glenohumeral arthritis; young patients; shoulder arthroplasty; biologic resurfacing; human dermal
matrix allograft; platelet rich plasma
This study was reviewed and approved by the Institutional Review Board
of IRB Services (FL IRB registration #IRB00006338).
*Reprint requests: Eddie Y. Lo, MD, Center of Sports Medicine, St.
Francis Memorial Hospital, 900 Hyde St, 11th Floor. San Francisco, CA
94109, USA.
E-mail address: Eddielomd@gmail.com (E.Y. Lo).
www.elsevier.com/locate/ymse
ARTICLE IN PRESS
1058-2746/$ - see front matter © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.jse.2015.11.063
J Shoulder Elbow Surg (2016) ■■, ■■–■■