Electronic Letters to:

Upper Limb: A. Cil, C. J. H. Veillette, J. Sanchez-Sotelo, J. W. Sperling, C. Schleck, and R. H. Cofield Revision of the humeral component for aseptic loosening in arthroplasty of the shoulder J Bone Joint Surg Br 2009; 91-B: 75-81 [Abstract] [Full text] [PDF]

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Revision of the humeral stem: why use a stem at all?

David M Ricketts, Ian Gill, Rehan Siddiqi   (13 January 2009)

Revision of the humeral stem: why use a stem at all? 13 January 2009
David M Ricketts, orthopaedic surgeon Princess Royal Hospital, Haywards Heath,West Sussex, England, RH17 5LP, Ian Gill, Rehan Siddiqi Send letter to journal: Re: Revision of the humeral stem: why use a stem at all? consultdmr{at}aol.com David M Ricketts, et al.	Sir, We read with interest this paper by Cil et al concerning revision of the humeral stem for aseptic loosening. We note the comments in the introduction stating that loosening of the glenoid component was more commonly found, and that a total of 290 humeral components were revised in the time studied. Of the 44 patients reviewed, 14 had intra-operative complications, four later needed revision and there was a high rate of instability. In our experience cementless resurfacing hemiarthroplasty for the primary operation avoids many of these problems. The results of total shoulder replacement and hemiarthroplasty in osteoarthritis of the shoulder are similar. Without a glenoid, no problems due to glenoid loosening are encountered. Furthermore, use of a resurfacing hemiarthroplasty prosthesis avoids several severe complications at primary surgery (i.e. humeral shaft and periprosthetic fractures). Should the need for revision surgery arise (as in Cil's paper), these procedures are easily performed, as bone stock has been maintained and no loss of length has been encountered.1 D.M. Ricketts, Orthopaedic Surgeon, I. Gill, R. Saddiqi, Princess Royal Hospital, Haywards Heath, England, UK. 1. Levy O, Copeland SA. Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder. J Bone Shoulder Elbow Surg 2004;13:266-71.