Authors’ Disclosure Statement: Dr. Throckmorton reports that he receives royalties and consultant fees from Zimmer Biomet, consulting fees from Pacira, and publishing royalties from Saunders/Mosby-Elsevier. Dr. Power reports no conflict of interest in relation to this article.
Dr. Power is a Sports, Shoulder, and Elbow Fellow, and Dr. Throckmorton is Professor, Residency Program Director, University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and Biomedical Engineering, Memphis, Tennessee.
Address correspondence to: Thomas W. Throckmorton MD, 1211 Union Avenue, Suite 510, Memphis, TN 38104 (tel, 901-759-3270; fax, 901-759-3278; email, tthrockmorton@campbellclinic.com).
Ian Power, MD Thomas W. Throckmorton, MD . Treating Humeral Bone Loss in Shoulder Arthroplasty: Modular Humeral Components or Allografts. Am J Orthop. February 15, 2018
TAKE-HOME POINTS
Proximal humeral bone loss presents a significant challenge for the shoulder arthroplasty surgeon.
Unsupported long-stemmed humeral components in this setting are prone to early loosening.
APCs can rebuild proximal humeral bone stock, but have concerns with graft resorption and long-term failure.
Modular endoprosthetic reconstruction of proximal humeral bone loss potentially allows those deficiencies to be addressed in a more durable fashion.
Longer-term and larger studies are needed to determine the optimal reconstruction technique for proximal humeral bone loss.
References
ABSTRACT
Reconstructing proximal humeral bone loss in the setting of shoulder arthroplasty can be a daunting task. Proposed techniques include long-stemmed humeral components, allograft-prosthesis composites (APCs), and modular endoprosthetic reconstruction. While unsupported long-stemmed components are at high risk for component loosening, APC reconstruction techniques have been reported with success. However, graft resorption and eventual failure are significant concerns. Modular endoprosthetic systems allow bone deficiencies to be reconstructed with metal, which may allow for a more durable reconstruction.
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