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General Orthopaedics

A “CONVERTIBLE” HUMERAL STEM: A STEP FORWARD IN REVISION TSA

Current Concepts in Joint Replacement (CCJR) – Spring 2015



Abstract

Revision shoulder arthroplasty for failure secondary to soft tissue problems has improved with the availability of the reverse total shoulder system. The initial concept of a platform (convertible) stem was introduced in 2006. Removal of a well-fixed humeral stem can be a significant challenge and may require the surgeon to use osteotomy windows to successfully remove the implant. The increased time in the operating room, potential for complications and the cost of replacing the humeral component are all factors that make platform stem use a important consideration. The first report on total shoulder arthroplasty revision utilizing the platform stem concept confirmed improvements in patient morbidity and decreased costs. However, the overall functional improvement did not reveal a statistically significant improvement in pain relief or range of motion compared to those patients that had the humeral stem revised. Almost all major companies have adopted this concept of a convertible stem system for shoulder arthroplasty.