Revision for failed anatomic total shoulder with a CTA hemiarthroplasty

A man in his mid 70s presented with progressive pain and weakness after an anatomic total shoulder performed 24 years ago. He had active elevation of the arm to 90 degrees and 4/5 muscle strength.

His radiographs at the time of presentation showed a superiorly displaced humeral head on a worn glenoid component.

He was revised by glenoid component removal and exchange of humeral head to an extended articular component (CTA hemiarthroplasty).

His postoperative films show centering of the humeral component in a concave glenoid.

At 6 weeks after surgery he had a comfortable shoulder with assisted elevation to 140 degrees.

 

Comment: Perhaps not all failed anatomic total shoulders need to treated with revision reverse total shoulders, a procedure with a complication rate of up to 40%  (see this link). Thanks to our shoulder fellow alumnus, Joe Lynch, for sharing this case with us.

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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).