Wednesday, July 25, 2012

Hemiarthroplasty for avascular necrosis

It is relatively unusual to find arthritis on just the humeral side of the shoulder joint. An exception is avascular necrosis of the humeral head if caught before the rough humeral articular surface destroys the glenoid surface.

Here are the films of the left shoulder of an individual successfully treated for leukemia while a teenager. The treatment included large doses of steroids. Four years later the left shoulder the left shoulder presented with painful clicking and popping. X-rays are shown here.
We performed a cementless hemiarthroplasty using autografting to fix the stem at which time the glenoid cartilage was intact, although somewhat fibrillated.

One year later the shoulder has full range of motion and minimal discomfort.

Recently the patient presents with similar findings of the opposite shoulder.

The surgical findings looked like this.

For which we performed an identical arthroplasty to that on the opposite side.


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