Bone-preserving total shoulder and reverse total shoulder arthroplasty - a simple approach - Muin1 me

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Bone-preserving total shoulder and reverse total shoulder arthroplasty - a simple approach

Today we had the pleasure of seeing a lady for routine followup of bilateral shoulder arthroplasties. On the right side a reverse total shoulder was performed because of the combination of cuff deficiency and arthritis. Here are her preoperative films,
 showing posterior decentering on the axillary 'truth' view
and her postoperative films showing secure, but bone-preserving fixation of the glenoid component and bone-preserving, cementless impaction autograft fixation of a non-ingrowth, thin-stemmed humeral component.


She had a standard total shoulder performed on the left because of arthritis with an intact cuff.

Her preoperative films are shown here


 showing posterior decentering on the axillary 'truth' view


and her postoperative films showing secure but bone-preserving fixation of the glenoid component and bone-preserving, cementless impaction autograft fixation of a non-ingrowth, thin-stemmed humeral component.


While several different approaches to bone preservation in shoulder arthroplasty have been proposed, the methods above appear to preserve at least as much bone as any of the alternatives, while still optimizing component orientation and fixation and avoiding stress-shielding.
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