Wednesday, January 25, 2017

Revising a canal sparing humeral component

Recently we had the opportunity to revise a total shoulder because of a loose glenoid component presenting 2.5 years after implantation. As seen in the x-rays below, the arthroplasty had been performed using a short 'canal sparing' humeral component.

Because of concern about infection, a single stage revision was planned.

The available instrumentation did not enable the removal of the well-fixed humeral component. Thus we created a 'springboard notch' in the component using a pinecone bur. This notch enabled removal of the component by impacting upwards in the notch with a bone tamp.

After removal of the loose glenoid component, a standard stem was fixed securely using impaction allografting. The insertion of the standard stem was accomplished without needing to remove any additional bone.

In logging a springboard notch supports a plank inserted to give the logger a more advantageous approach to the trunk of the tree.

See also these related posts:

Total shoulder and short stems: less is not more