A middle aged patient presented with pain and clicking in the shoulder after a prior total shoulder joint replacement.
The x-ray below shows that a large sized stem incarcerated in the humeral diaphysis preventing full seating of the humeral component. As a result the humeral head rested on the superior aspect of the glenoid giving rise to rocking horse loosening of the glenoid component. The keeled glenoid component had been inserted with a lot of cement so that when the loose component was removed a large defect in the glenoid bone was left.
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