What might be learned from this failed total shoulder?

A middle aged patient presented with pain and clicking in the shoulder after a prior total shoulder joint replacement. 

The x-ray below shows that a large sized stem incarcerated in the humeral diaphysis preventing full seating of the humeral component. As a result the humeral head rested on the superior aspect of the glenoid giving rise to rocking horse loosening of the glenoid component. The keeled glenoid component had been inserted with a lot of cement so that when the loose component was removed a large defect in the glenoid bone was left. 

Rocking horse loosening from eccentric loading is a common contributor to glenoid component failure.  A smaller stem fully inserted and fixed with impaction grafting may have avoided humeral component malpositioning. Using a pegged glenoid component inserted with minimal cement may have reduced the amount of glenoid bone loss.
=====
Use the "Search" box to the right to find other topics of interest to you.

How you can support progress in shoulder surgery

You may be interested in some of our most visited web pages   arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'