Sunday, June 21, 2015

Shoulder joint replacement arthroplasty - do short stems offer an advantage?

These authors reviewed the radiographs of 44 shoulder arthroplasties using a short uncemented humeral stem of which 6 shoulders (14 %) showed features of stress shielding at the medial cortex.

Comment: While it is suggested that this prosthesis is bone conserving, cementless and facilitating of revision, it may carry the risks of creating a stress riser at the tip of the stem and of producing bone resorption of the unloaded bone proximal to the tip.

We have previously posted on the potential problems of "shorty" prostheses here.

Our preference is to minimize the risk of stress shielding and periprosthetic fracture by using impaction grafting to secure the humeral prosthesis without contacting the cortex. As shown in the two year postoperative films below, this approach preserves bone and enables easy prosthesis removal should that ever become necessary.


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