Saturday, March 16, 2013

Long stem humeral components in arthroplasty revision

Utility and complications of long-stem humeral components in revision shoulder arthroplasty

These authors report the minimum two year followup on 80 revision shoulder arthroplasties. Intermediate or long stem were used for proximal bone loss in 40, nonunion in 14, a malpositioned previous stem with bone loss in 10, an acute intraoperative fracture in 7, an acute preoperative periprosthetic fracture in 5, diaphyseal bone loss in 2, and a box-shaped osteotomy to remove a well-fixed stem in 2. Clinical follow-up was an average of 5.9 years, and radiographic follow-up was an average of 4.7 years.

Intraoperative complications included fracture removing the previous stem in 5, a cortical perforation in 6, and cement extrusion in 7. Late complications included fracture nonunion in 5, deep infection in 2, and component loosening in 1.