Tuesday, June 16, 2015

Fixed posterior subluxation - management with an anteriorly eccentric humeral head component

These preoperative x-rays are of the left shoulder of an active 50 year old.

While some surgeons may choose to manage this situation with a reverse total shoulder, we chose to manage this example of the BAT (bad arthritic triad) by reaming the glenoid to a single concavity and using an anteriorly eccentric humeral head component with the result shown below. At the time of surgery the shoulder was stable against posteriorly directed loads applied to the proximal humerus.

On rounds the first day post surgery she demonstrated 130 degrees of passive elevation with no sensation of posterior instability. This is in comparison to 80 degrees of elevation preoperatively.

For a related post describing our approach to the Bad Arthritic Triad see here.

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