A novel surgical procedure for osteonecrosis of the humeral head: reposition of the joint surface and bone engraftment.

A novel surgical procedure was performed on a 33-year-old woman with idiopathic osteonecrosis of the head of the left humerus. The operation involved repositioning of the joint cartilage and bone engraftment through her humeral head from under the greater tuberosity with shoulder arthroscopy. The patient wore an abduction brace for 8 weeks after the operation to hold the joint surface in its new position. This surgical procedure resulted in considerable improvement of the functional status of the shoulder by relieving pain and increasing range-of-motion. A preoperative radiograph showed stage IV osteonecrosis of the humeral head. However, at follow-up, repositioning of the joint surface and improvement of the necrotic bone were observed by radiography and magnetic resonance imaging.