How to secure the humeral component safely and securely

An impaction grafted standard length humeral stems provides secure fixation that preserves bone, enables the use of eccentric head components of different thickness, avoids stress shielding and fracture, and permits easy removal should revision become necessary. 

Impaction grafting effectively manages the challenge of the variable medullary anatomy of the humerus (which cannot be matched by any prosthesis), while avoiding the problem of endosteal notching.

Impaction grafting fits the patient to the prosthesis, in this is regard it reminds us of the mythological character, Procrustes (see this link).

Here are some relevant references

Boorman, R., Hacker, S., Lippitt, S.B., and Matsen III, F.A.:  A Conservative Broaching and Impaction Grafting Technique for Humeral Component Placement and Fixation in Shoulder Arthroplasty: The Procrustean Method. Techniques in Shoulder & Elbow Surgery. 2(3): 166-175, September 2001.

 

Hacker, S., Boorman, R., Lippitt, S.B., and Matsen III, F.A.:  Impaction grafting improves the fit of proximal humeral arthroplasty. JSES, 12(5):431-435, 2003.

 

Lucas RM, Hsu JE, Gee AO, Neradilek MB, Matsen FA 3rd. Impaction autografting: bone-preserving, secure fixation of a standard humeral component. J Shoulder Elbow Surg. 2016 Nov;25(11):1787-1794.

 

Denard PJ, Hsu JE, Whitson A, Neradilek MB, Matsen FA 3rd. Radiographic outcomes of impaction-grafted standard-length humeral components in total shoulder and ream-and-run arthroplasty: is stress shielding an issue? J Shoulder Elbow Surg. 2019 Nov; 28(11): 2181-2190.

How you can support research in shoulder surgery Click on this link.

Here are some videos that are of shoulder interest

Shoulder arthritis - what you need to know (see this link).

How to x-ray the shoulder (see this link).

The ream and run procedure (see this link).

The total shoulder arthroplasty (see this link).

The cuff tear arthropathy arthroplasty (see this link).

The reverse total shoulder arthroplasty (see this link).

The smooth and move procedure for irreparable rotator cuff tears (see this link).

Shoulder rehabilitation exercises (see this link).