The Management of Localized Articular Cartilage Lesions of the Humeral Head in the Athlete

Localized articular cartilage lesions of the humeral head can be a source of persistent pain and functional decline in patients who have failed conservative treatment measures. Many are younger, active patients who pose a challenging management decision for surgeons. The goals of treatment should focus on maintaining humeral bone stock, restoring the contour of the articular surface, minimizing soft-tissue disruption, and relieving symptoms. There has been a trend toward humeral resurfacing arthroplasty and away from stemmed components over the past few decades for younger patients potentially requiring future revision surgery. More recently, the HemiCAP resurfacing system (Arthrosurface, Franklin, MA) has been used for localized defects in patients with Hill-Sachs and reverse Hill-Sachs lesions, avascular necrosis, focal chondral defects, and humeral head osteoarthritis. Early, short-term outcome results of the HemiCAP system are encouraging. In this article, we describe our technique for management of localized articular cartilage defects of the humeral head using the HemiCAP resurfacing system.