Implant designers seem to have great interest in trying to invent new solutions to problems that have already been solved. One example is shortening the humeral stem. We've posted on the problems of 'shorty' implants in the past. As shown in a revision case we did yesterday, the risk of a short stem is that it increases the risk of its being positioned in varus, resulting in overstuffing of the joint, loss of range of motion and glenoid component failure.
We revised the shoulder by removing the humeral and glenoid components, inserting a new glenoid component, punching through the pedistal at the stem tip and inserting a standard length prosthesis with impaction allograft as shown in the post operative film below.
The stem removal was difficult requiring humeral osteotomy because of the excessively tight diaphyseal incarceration, but the reconstruction was straightforward - again using an impaction allografted stem as shown below.
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