Proximal Humeral Bone Loss in Revision Shoulder Arthroplasty

Orthop Clin North Am. 2020 Jan;51(1):87-95. doi: 10.1016/j.ocl.2019.08.003. Epub 2019 Oct 14.

Abstract

Proximal humeral bone loss in revision shoulder arthroplasty poses a significant obstacle to achieving stable and reliable fixation of the humeral stem. It is important to identify and classify this bone loss preoperatively, which can range from epiphyseal to substantial diaphyseal bone loss. There are several reconstructive options that can address the varying levels of bone loss, including cemented long-stem fixation, a composite construct using proximal humeral allograft or femoral allograft, proximal humeral endoprosthetic replacement, or total humeral replacement. All of these are viable reconstructive options that have demonstrated adequate to good outcomes.

Keywords: Allograft prosthesis composite; Humeral endoprosthesis; Proximal humeral bone loss; Revision shoulder arthroplasty.

Publication types

  • Review

MeSH terms

  • Allografts / transplantation
  • Arthroplasty, Replacement / adverse effects*
  • Arthroplasty, Replacement / methods
  • Arthroplasty, Replacement, Shoulder / adverse effects*
  • Bone Cements
  • Bone Resorption / classification
  • Bone Resorption / diagnostic imaging
  • Bone Resorption / pathology
  • Epiphyses / pathology
  • Epiphyses / surgery
  • Humans
  • Humerus / diagnostic imaging
  • Humerus / pathology*
  • Humerus / surgery
  • Joint Prosthesis
  • Postoperative Complications / surgery
  • Preoperative Period
  • Prostheses and Implants
  • Radiography
  • Range of Motion, Articular / physiology
  • Treatment Outcome

Substances

  • Bone Cements