Her plain x-ray looked like this
and her MRI revealed the diagnosis of avascular necrosis with a crack below the joint surface of the humeral head.
A hemiarthroplasty performed with impaction grafting of a press fit implant gave her excellent return of comfort and function.
A year later she returned with similar symptoms on the opposite side and this x-ray.
and this MRI
A second humeral hemiarthroplasty has restored comfort and function to this shoulder.
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At surgery the humeral head showed central collapse
It is to be noted that the hemiarthroplasty with impaction grafting allowed for anatomic reconstruction of the shoulder, secure fixation of the humeral component, and freedom from cement or bone ingrowth that would complicate future revision surgery should it become necessary.
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