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.
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.
See also these related posts:
Short stem humeral prosthesis: the risk of stress shielding. Is shorter better?
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