For patients with a comminuted proximal humerus fracture or advanced avascular necrosis, humeral head replacement has been shown to yield excellent results, provided the glenoid and rotator cuff are preserved. In young patients, however, the long-term outcomes after prosthetic humeral head replacement may be limited by the higher functional demands placed on the glenohumeral joint. The development of glenoid arthrosis is a recognized complication of proximal humerus replacement and may contribute to less satisfactory pain relief and shoulder function. Loss of glenoid cartilage may necessitate conversion to a total shoulder arthroplasty, because there are limited surgical options to treat glenoid wear after humeral head replacement.
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