Friday, October 24, 2014
Get Shorty? Are short stemmed humeral components an advantage?
There has been recent interest in shorter stemmed humeral components - sometimes called 'mini' or even 'micro' stems. While the suggested advantages are (1) preservation of more humeral bone and (2) easier fit in the humeral canal, what is sacrificed is the ability of the longer stem to assure proper orientation of the humeral head with respect to the humerus. This problem is shown on the x-rays below of a case recently presenting to us. While the prosthesis appears properly oriented
The axillary view shows the stem in substantial anterior inclination, with lack of coverage of the posterior proximal humerus and a tendency for anterior subluxation. A revision was required.
Here are the x-rays of a man we saw back this week who is one year out from a ream and run procedure with our standard approach to humeral component selection and fixation - no cement, no ingrowth, no loss of endosteal bone through reaming, no valgus, no varus, no angulation, no loosening, no plastic glenoid and 12/12 on the Simple Shoulder Test.
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