Total shoulder instability - conservative management

A patient had a left total shoulder after which the shoulder demonstrated anterior and posterior instability with activities of daily living.

The x-rays at the time of presentation to our clinic are shown below. The humeral head was a 42X18X46.

 At revision surgery, the glenoid and humeral components were secure as was the subscapularis. The shoulder was grossly unstable anteriorly and posteriorly.

Although the preoperative plan included the possibility of converting to a reverse total shoulder, trialing with different humeral head components demonstrated that the shoulder was stabilized with use of a 50X21X57 humeral head inserted with 4 mm inferior eccentricity to optimize the alignment of the head to the glenoid component.

The postoperative films are shown below.

The patient has been able to participate in the standard postoperative rehabilitation and has full passive range of motion without evidence of the instability that was present before surgery.

Comment: This case demonstrates the importance of examining shoulder motion and stability at the time of arthroplasty and the utility of a large diameter of curvature on the humeral head component and optimizing alignment of the head to the glenoid in establishing stability on the small glenoid component.

==
To see a YouTube of our technique for total shoulder arthroplasty, click on this link.

=====

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

Use the "Search" box to the right to find other topics of interest to you.

How you can support progress in shoulder surgery

=====

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

Use the "Search" box to the right to find other topics of interest to you.

How you can support progress in shoulder surgery