Resurfacing of the humeral head

Large full-thickness cartilage defects of the proximal humeral are known to be a cause for severe shoulder pain, mostly in patients of younger age. If conservative or prior joint preserving treatment fails, resurfacing of the humeral head may be seen as a treatment option to restore full shoulder function and relieve pain. To date, the two most commonly used implants are the Partial Eclipse implant (Arthrex, Naples, FL, USA) and the HemiCAP implant (Arthrosurface, Franklin, MA, USA). Historically, the Arthrosurface prosthesis is implanted in an open fashion, whereas the Eclipse implant was designed to be implanted via a minimal-invasive technique. However, both implants are similar in design, and both provide inlay resurfacing. Overall, partial resurfacing of the humeral head should be reserved for younger patients, who may have a higher probability to undergo future revision procedures. In contrast, when it comes to glenohumeral osteoarthritis in the young and active patient with high demands and expectations, humeral head resurfacing (HHR) is an option to avoid problems associated with the glenoid and humeral stems, which in young patients have unacceptably high rates of early loosening. HHR is designed to avoid humeral osteotomy, which leads to advantages when compared to traditional stems: bone stock savings by preserving the neck and >50% of the humeral head, neck-diaphyseal angle, version, inclination, center of original rotation and offset. In theory, by not modifying the original anatomy of the proximal humerus, resurfacing revisions can be done with conventional replacements, which, in young patients, is a clear advantage in saving time in the scenario of possible failure.