The month of July 2016 has featured many different approaches to fixation of the humeral head prosthesis to the humerus that we encountered in the last few weeks of our referral practice of revision surgery. Each of these revisions was technically challenging, but they have one thing in common: all revisions were accomplished using an impaction grafted smooth stem (making one wonder if that method of fixation might have been preferable for the primary procedure).
The trabeculated stem shown the image below of a dislocated humeral prosthesis required humeral osteotomy for removal before insertion of an impaction grafted reverse shoulder prosthesis.
The resurfacing humeral component required removal in the revision of a failed glenoid component after which an impacting grafted smaller diameter smooth stem prosthesis was used.
It was revised to a standard stem length prosthesis without any additional bone removal (in fact with the addition of cancellous allograft).
Each of these revised humeral components present their own particular challenges. Our preference remains the impaction grafted stem inserted with minimal endocortical contact because of its virtually universal applicability (as shown in the two ream and run cases we did yesterday, see below) .
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You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
