Wednesday, January 18, 2017

Humeral component eccentricity - getting it right

A 70 year old patient presented with painful clunking in the left shoulder after a prior arthroplasty. The anteroposterior view shown below indicates well fixed humeral and glenoid components. 


However, the 'truth' view, revealed a posteriorly sublimated humeral head that had been placed with the eccentricity directed posteriorly.

At the revision surgery, we found that the glenoid component was well fixed, but that the posterior glenoid polyethylene was severely eroded. We removed the glenoid component, smoothed the residual glenoid bone, placed an anteriorly eccentric humeral component, and performed a rotator interval plication.

At surgery and as seen in the postoperative 'truth' view,  the shoulder is now posteriorly stable.
Comment: This case demonstrates the value of the 'truth' view as well as the importance of proper orientation of humeral head eccentricity.

More about the 'truth' view can be seen here,  here, and here.

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