This paper demonstrates a templating method for measuring the cortical bone displacement for rectangular humeral stems with the goal of optimizing stem fixation and minimizing risk of periprosthetic fracture. As they point out, intraoperative insertion forces during broaching and implant insertion can be quite high, risking either fracture or failure to fully seat the component.
As our regular readers know, we take a different approach - being careful to avoid any broaching or reaming of the diaphysis (love at first bite) and safely achieving the desired fit with impaction grafting. The nice things about this technique is that (1) templating is not required, (2) it uses a standard tapered prostheses, and (3) the surgeon can readjust the prosthesis position if necessary by removing the prosthesis and either adding or removing graft (get it wrong and still get it right). This approach has enabled us to avoid periprosthetic fracture on one hand and humeral component loosening on the other.
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If you have suggestions for topics you'd like us to address in this blog, please send an email to
shoulderarthritis@uw.edu
Use the "Search the Blog" box to the right to find other topics of interest to you.
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.
