Humeral component revision arthroplasty: outcomes of a split osteotomy technique

Johnston, Peter S.; Creighton, R. Alexander; Romeo, Anthony A.

doi:10.1016/j.jse.2011.02.001

Cited by 30 publications

(6 citation statements)

References 22 publications

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“…Different techniques have been described in the literature. Even so, there are also technique-related complications such as non-union of the cortical window, dislocation, and fracture (Johnston et al 2012, Gohlke and Rolf 2007, Sperling and Cofield 2005). Walker et al (2012) studied 22 patients following revision of failed total shoulder arthroplasty with a reverse implant, with extraction of the humeral shaft.…”

Section: Discussionmentioning

confidence: 99%

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Revision to reverse shoulder arthroplasty with retention of the humeral component

Werner¹,

Boehm²,

Gohlke³

2013

Acta Orthopaedica

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BackgroundRevision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss. Newer modular systems allow conversion from anatomic to reverse shoulder arthroplasty with retention of a well-fixed humeral stem. We report on a prospectively evaluated series of conversions from hemiarthroplasty to reverse shoulder arthroplasty.MethodsIn 14 cases of failed hemiarthroplasty due to rotator cuff deficiency and painful pseudoparalysis (in 13 women), revision to reverse shoulder arthroplasty was performed between October 2006 and 2010, with retention of the humeral component using modular systems. Mean age at the time of operation was 70 (56–80) years. Pre- and postoperative evaluation followed a standardized protocol including Constant score, range of motion, and radiographic analysis. Mean follow-up time was 2.5 (2–5.5) years.ResultsMean Constant score improved from 9 (2–16) to 41 (17–74) points. Mean lengthening of the arm was 2.6 (0.9–4.7) cm without any neurological complications. One patient required revision due to infection.InterpretationModular systems allow retainment of a well-fixed humeral stem with good outcome. There is a risk of excessive humeral lengthening.

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Section: Discussionmentioning

confidence: 99%

“…Removal of cement and the humeral component may require a humeral cortical window. In some cases, there may not be enough humeral bone stock left for stable reconstruction of the revision stem afterwards (Sperling and Cofield 2005, Gohlke and Rolf 2007, Johnston et al 2012). …”

mentioning

confidence: 99%

Revision to reverse shoulder arthroplasty with retention of the humeral component

Werner¹,

Boehm²,

Gohlke³

2013

Acta Orthopaedica

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“…Long-term concerns associated with humeral stems include proximal humeral bone loss due to stress shielding, humeral stem loosening, and osteolysis 13,14,17 . For patients who require surgical treatment, removal of a well-fixed humeral stem can be difficult and can result in additional destruction of proximal humeral bone [21][22][23][24] . Ultimately, bone loss, regardless of its etiology, can limit reconstructive options and the clinical success of revision operations 8,21,23,24 .…”

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confidence: 99%

Clinical and Radiographic Outcomes of the Simpliciti Canal-Sparing Shoulder Arthroplasty System

Churchill

Chuinard

Wiater

et al. 2016

The Journal of Bone and Joint Surgery

113

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“…This study included 56 patients with various preoperative conditions, massive cuff tear (20), cuff tear arthropathy (33), and primary osteoarthritis (3). At follow-up, significant improvements were demonstrated in the Constant score which increased from 29 to 62 and Oxford score which decreased from 46 to 17.…”

Section: Reverse Stemless Shoulder Arthroplasty Resultsmentioning

confidence: 99%

Stemless shoulder arthroplasty—current results and designs

Churchill

Athwal

2016

Curr Rev Musculoskelet Med

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Stemless shoulder arthroplasty was originally introduced in 2004 by a single manufacturer. Now, over a decade later, numerous designs are available outside the USA, but as yet, only one implant has been cleared by the Food and Drug Administration (FDA) and is available for use within the USA. Often referred to as Bcanal sparing,^these implants are designed for metaphyseal fixation to minimize humeral bone removal, avoid intraoperative and postoperative humeral fracture complications, and to decrease morbidity associated with revision operations. Recently, the second generation of stemless arthroplasty, a convertible implant allowing use in either anatomic or reverse arthroplasty configuration, was released for use outside the USA. This paper will review the available designs, reported results, and raise potential concerns for this emerging technology.

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Humeral component revision arthroplasty: outcomes of a split osteotomy technique

Cited by 30 publications

References 22 publications

Revision to reverse shoulder arthroplasty with retention of the humeral component

Revision to reverse shoulder arthroplasty with retention of the humeral component

Clinical and Radiographic Outcomes of the Simpliciti Canal-Sparing Shoulder Arthroplasty System

Stemless shoulder arthroplasty—current results and designs

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