1. “PROTESIS DE HOMBRO Y ROTURA CRONICA DEL MANGUITO ROTADOR” 27.03.03
II JORNADAS CLINICO QUIRURGICAS SOBRE
PATOLOGIA DE LA EXTREMIDAD SUPERIOR
“PROTESIS DE HOMBRO Y
ROTURA CRONICA DEL
MANGUITO ROTADOR”
DR. ROCKWOOD,C.A. Jr.
UNIVERSIDAD SAN ANTONIO, TEXAS
DR. DE WILDE, L.
HOSPITAL UNIVERSITARIO DE GENT, BÉLGICA
DR. MARCO, F.
HOSPITAL SAN CARLOS, UNIV. COMPLUTENSE. MADRID
COORDINACIÓN: DR. GUERRA GARCIA, C.
HOSPITAL DE CABUEÑES, GIJON
SERVICIO DE C.O.T.
PROF. A. MURCIA MAZON

2. RESULTS OF SHOULDER ARTHROPLASTY IN OSTEOARTHRITIS
DR. ROCKWOOD, CH. A. Jr.

3. SURE I DO, BUT ONLY FOR THE PROPER INDICATIONS !!!
DO I REPLACE THE GLENOID ??
SURE I DO, BUT ONLY FOR THE PROPER INDICATIONS !!!

4. MANY patients do well with a HA SOME patients require a TSA
SHOULDER ARTHROPLASTY IS A VERY SUCCESSFUL PROCEDURE
MANY patients do well with a HA SOME patients require a TSA

5. INDICATIONS FOR TOTAL SHOULDER ARTHROPLASTY
Non concentric glenoid
When ant. or post. glenoid is eroded 150 or more
When HA does not produce a stable shoulder with soft tissue balance

6. INDICATIONS FOR HA Fx – 3 and 4 part AVN Most cases of OA
Most cases of RA
Arthritis and no cuff
Most revisions of TSA

7. NEER – 1990
“I used this prosthesis during a 20 year period, until 1973, and it is still preferred by some surgeons”
Excellent results when:
- good cuff
- good deltoid
- good rehab
and a good glenoid !

8. REVIEW OF SHOULDER HEMIARTHROPLASTY
NEER – 1990
“I continue to use the humeral component alone when the glenoid is normal.”
C.S. Neer II “ShoulderReconstruction” Text – W.B. Saunders – 1990 Chapter 3 – Glenohumeral Arthroplasty p

17. Pre op right shoulder

18. Post op glenoid reaming and HA

19. Post op Glenoid reaming and HA

20. NINE YEARS POST OP HEMIARTHROPLASTY

21. Pre Op ROM--Right

22. Pre Op ROM - Fraley

23. Pre revision ROM - Fraley

24. Post op TSA – Fraley

25. Post op TSA—Fraley

26. Post op revision HA to TSA 6 months

27. Post op revision HA – TSA – 6 months

28. Post op revision HA – TSA – 6 months

29. Post op revision HA – TSA – 6 months

30. I WORRY ABOUT GLENOID LOOSENING
Publications +/-30% loosening
Radioluscent lines – 30 – 90%
Cofield – 1983 – 2% loosening
Torchia 1995, 89 Sh – follow up 12 years
- 84% dev. radioluscent lines
- 46% dev. loosening with
increase in pain

33. SUMMARY HA vs TSA The results of HA in many series are equal to TSA
Modular prosthesis allows flexibility to balance the soft tissues
Ha can treat most patients with arthritis of the shoulder
HA can treat most arthritis and cuff deficient shoulders
HA eliminates glenoid wear concerns
HA eliminates the high rates of glenoid loosening

34. SHOULDER ARTHROPLASTY IS A VERY SUCCESSFUL PROCEDURE
SUMMARY
SHOULDER ARTHROPLASTY IS A VERY SUCCESSFUL PROCEDURE
MANY patients do well with a HA SOME patients require a TSA