In this day of discussion of 'platform' prostheses, stems that encourage bony ingrowth, trabecular metal and advocates for humeral component cementing, it is appropriate to point out that the combination of a tapered body and impaction grafting enables safe cementless fixation of the humeral component. This approach has the additional advantage of facilitating stem removal, should it become necessary.
The shape of the body is important. The two images on the left show that a press fit cannot be obtained with a cylindrical body. However, as is shown on the two images on the right, a tapered body allows a snug metaphyseal fit, especially if coupled with impaction grafting.
Here are five examples from our OR yesterday. Each of these prosthesis fit tightly within the impaction grafted humeral canal without wedging in the diaphysis (wedging can predispose to fracture at the tip of the prosthesis). Note the conservative broaching and the filling in of the space between the prosthesis and the endosteal cortex with graft harvested from the humeral head.
===
Check out the new Shoulder Arthritis Book - click here.
To see the topics covered in this Blog, click here
Use the "Search" 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 as well as the 'ream and run essentials'
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 as well as the 'ream and run essentials'
