Joint overstuffing in shoulder hemiarthroplasty

Case contributed by Dr Domenico Nicoletti

Presentation

Postoperative pain and functional shoulder limitation on abduction.

Patient Data

Age: 60 years
Gender: Female

Postoperative control (supine)

Humeral component in high position with normal acromiohumeral interval.

Twelve months control

Humeral component high position with significant reduction in the acromiohumeral interval.

In the axial projection, there is anterior humeral component subluxation.

Compared to the initial tilt, the prosthetic stem is in varus.

Case Discussion

The rotator interval defines the space available for the rotator cuff and is about 10 mm.

In shoulder arthroplasty, care should be taken not to use an oversized humeral head component and to perform glenohumeral capsular releases to accommodate the head (and in total arthroplasty, also glenoid) component, so as to avoid decreased range of motion and stiffness.

The normal distance between the humeral component head and the tuberosity should be 5 mm, higher than that is considered overstuffing.

In joint overstuffing, the tension and traction on the rotator cuff and the capsular ligamentous complex increase with arm elevation.

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Case information

rID: 53976
Case created: 16th Jun 2017
Last edited: 22nd Jun 2017
Inclusion in quiz mode: Included

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