There may be less of a chance of hip dislocation following a hemiarthroplasty compared to a thr, too. The shoulder hemiarthroplasty is most often performed for one of three reasons. This chapter details this commonly used surgical approach to the glenohumeral joint. Management of failed hemiarthroplasty with reverse. It was originally designed as an uncemented implant. The objective of this article is to describe the surgical technique for revising a. Pdf shoulder arthroplasty is most commonly performed via a deltopectoral dp or anterosuperior as approach, and several modifications.
The definitive book on reverse shoulder arthroplasty from leading orthopaedic shoulder surgeons. Feb 23, 2017 technical pitfalls of shoulder hemiarthroplasty for fracture management although most proximal humerus fractures can be treated nonoperatively, 4part fractures and 3part fracturesdislocations in elderly patients often require management with prosthetic arthroplasty. Use a drape to isolate the anesthesia equipment from the sterile field. Neviaser brings you up to speed with mustknow surgical techniques in todays technically demanding shoulder and elbow surg. Superior migration of the prosthesis can still occur due to rotator.
Surgical technique figure 6b the involved shoulder should extend over the table edge. Shoulder hemiarthroplasty for fractures of the proximal humerus. Orthopedic secrets fourth edition, 2015 related terms. The objective of this article is to describe the surgical technique for revising a shoulder hemiarthroplasty into a reverse prosthesis. Although humeral hemiarthroplasty can provide good results, there is some evidence that the comfort and function is less than a successful total shoulder arthroplasty. The axial starter reamer is used with the thandle to open the femoral canal and to aid in determining the orientation of the femoral axis. Shoulder hemiarthroplasty with nonprosthetic glenoid. The video journal of orthopaedics has provided a short view of the technique. Since its introduction, this prosthesis has remained a popular implant in the management of hip fractures. Hip hemiarthroplasty eau claire, wi hip fracture surgery. Present technical comparison of surgical fixation techniques reveals the stateoftheart approach and highlights promising techniques for. The purpose of this book was to offer an overview of recent insights into the. Hip hemiarthroplasty surgery royal oak femoral neck.
Present technical comparison of surgical fixation techniques reveals the stateoftheart approach and highlights promising techniques. Here is a technique intensive textbook of shoulder arthroplasty detailing how to handle all relevant aspects of shoulder replacement surgery. Stepbystep, evidencebased guidance walks you through both common and unique cases. Shawn odriscoll, md, phd mayo foundation, ken yamaguchi, md washington university, barnes jewish hospital graham king, md, msc university of western ontario 2 table of contents table. Part of the practical, highly illustrated operative techniques series, this fully revised title by drs. Immediate motion weeks 0 to 8 goals allow early healing of capsule increase passive range of motion decrease shoulder pain retard muscular atrophy and prevent rotator cuff inhibition brace discontinue use after six to eight weeks unless otherwise advised by dr. There are various indications for shoulder hemiarthroplasty. The procedure is performed under general anesthesia. To see more of the shoulder arthritis book, click here. Technical pitfalls of shoulder hemiarthroplasty for fracture. Technical pitfalls of shoulder hemiarthroplasty for.
Description a surgical procedure in which the humeral articular surface is replaced without. Femoral canal preparation use the box osteotome and canal finder for initial entry into femoral canal. The first is an arthritic shoulder where the socket is not in bad condition, but the ball needs to be replaced. The hip joint is one of the bodys largest weightbearing joints and is the point where the thigh. Jun 02, 2008 should jordan henderson win the pfa player of the year award. In a multicenter retrospective analysis, we analyzed 274 revision shoulder arthroplasties converted to a rsa n 182, anatomic total shoulder arthroplasty tsa, n 68, or.
Neviaser brings you up to speed with mustknow surgical techniques in todays technically demanding shoulder and elbow surgery. The procedure is performed under general anaesthesia. Shoulder hemiarthroplasty is the surgical resurfacing of the humeral head only with a metallic prosthetic implant. Success in shoulder arthroplasty surgery is not necessarily dependent only on the principle of construction of a prosthetic device nor the way. This masterful book from top experts provides clinical insights. Hemiarthroplasty for fracture neer type shoulderdoc by. Failure to anatomically secure the tuberosities, restore the humeral height, and recreate the appropriate humeral retroversion are the most likely reasons for failure. Position the patient so the involved shoulder extends over the top corner and edge of the table figures 6a and b. Written by the worlds foremost shoulder and elbow surgeons, this volume is the most comprehensive, current reference on shoulder and elbow arthroplasty. Francis mendoza will explain when a shoulder hemiarthroplasty is recommended. Shoulder hemiarthroplasty physical therapy protocol. Dec 10, 2019 background shoulder hemiarthroplasty is a shoulder replacement in which the broken humeral head is replaced with an artificial joint and the fractured bone is reconstructed around the artificial joint.
Surgical treatment of three and fourpart fractures of the proximal humerus with hemiarthroplasty is a safe and effective approach, the outcome of which appears to be related to the quality of the anatomical reconstruction of the tuberosities. The clinical outcome of hemiarthroplasty for proximal humeral fractures is not satisfactory. The hip joint is one of the bodys largest weightbearing joints and is the point where the thigh bone femur and the pelvis acetabulum unite. The surgeon gains access to the hip joint and the head of the femur is removed using surgical instruments and prepared to accept the prosthesis. Sep 16, 2019 the reverse shoulder replacement was designed for that issue. Fractures are extremely rare with the impaction bone grafting technique. The recovery from a reverse total shoulder is much different than recovery from an orif, intramedullary rod, or hemiarthroplasty. Proximal humerus fracture book twin cities orthopedics. While enthusiasm for hemiarthroplasty has waned, especially in the setting of osteoarthritis, the painful hemiarthroplasty continues to be a frequent presenting complaint in the shoulder specialists office. As shoulder arthroplasty is increasing, the expected amount of revisions is expected to increase accordingly. A surgeon must decide between a hemiarthroplasty or a total shoulder arthroplasty when performing shoulder replacement surgery. Review of fixation techniques for the fourpart fractured. Shoulder hemiarthroplasty physical therapy protocol phase i. Shoulder arthroplasty for proximal humerus fractures.
The exposure and the humeral side of the arthroplasty. Hemiarthroplasty does not disturb the glenoid and is a lesser procedure. Hemiarthroplasty shoulder surgery understanding your treatment plan this handout explains care after your shoulder surgery while you are in the hospital, and also details care issues while you recover at home. Total shoulder arthroplasty a general description can be seen here.
Infection rates after shoulder arthroplasty are relatively low. Dec 10, 2019 shoulder hemiarthroplasty is a shoulder replacement in which the damaged humeral head is replaced with a prosthetic humeral head. Conversion of failed hemiarthroplasty to reverse total. A trauma hemiarthroplasty system combined with good surgical technique can ensure tuberosity fixation and subsequent union. Shoulder hemiarthroplasty an overview sciencedirect topics. Galatz, in case competencies in orthopaedic surgery, 2017. Rehabilitation for total shoulder replacement part i.
The use of shoulder hemiarthroplasty and humeral head. Success in shoulder arthroplasty surgery is not necessarily dependent only on. Complex issues in the primary and revision setting assembles the clinical knowledge of leading orthopedic surgeons treating patients with arthritic shoulders. Total shoulder arthroplastyhemiarthroplasty protocol phase i. Pdf i surgical approaches for shoulder arthroplasty.
Hip hemiarthroplasty surgery houston, tx hip fracture. Hip hemiarthroplasty is a surgical technique employed to treat hip fractures. Surgical approaches in shoulder arthroplasty intechopen. Background shoulder hemiarthroplasty is a shoulder replacement in which the broken humeral head is replaced with an artificial joint and the fractured bone is reconstructed around the artificial joint. Secondary fragment dislocation may prevent bone integration. Thompson hemi hip stem surgical technique depuy synthes 1 introduction the thompson hemiarthroplasty was first reported in the mainstream orthopaedic literature in 1954. Stepbystep, evidencebased guidance walks you through both common and unique cases youre likely to see in your practice, while tips. The most common complications following primary hemiarthroplasty for proximal humerus fractures relates to surgical technique. Shoulder arthroplasty is a complex procedure that is becoming increasingly more. The aim of this book chapter is to describe the methodology for approaching. Hip hemiarthroplasty south bend hip fracture treatment. In this procedure, only one half ball section of the hip joint is substituted by a metal prosthesis. Written by leading shoulder specialists, the book provides surgeons and rehabilitation.
A humeral hemiarthroplasty is not the same as a ream and run. Shoulder arthroplasty is a rapidly evolving area of orthopedics focused on treating specific, painful ailments of the glenohumeral articulation. While use of an axial starter reamer is needed, use of cylindrical reamers is not necessary to prepare the femoral canal. The book provides stateoftheart information on implant design and detailed guidelinesincluding treatment algorithmson specific arthroplasty procedures for arthritis, fractures, chronic dislocations, and other disorders. Stateofthe art techniques for shoulder replacement surgery. Revision to a reverse shoulder replacement is a viable salvage option in these patients. This protocol was adapted from the articles titled. Precise surgical technique is critical for success, with proper tension of capsular, muscular, and tendinous surfaces needed for stability. Glenoid wear is a particular risk when the quality of the bone is poor or when the glenoid surface is not congruent with the humeral prosthesis.
Clear, evidencebased coverage details which technology and methodology used for total shoulder arthroplasty, reconstruction or revision is best for. By using the anatomic landmarks referenced during preoperative xray templating, the preplanned neck resection is made with an oscillating saw and with the aid of the neck resection guide. Shoulder hemiarthroplasty replaces half of the joint. The book presents practical approaches to surgically managing each type of arthritis, the.
May 29, 2016 shoulder hemiarthroplasty young lae moon. Revision rates and quality of life indicators are also comparable to that of total shoulder prostheses. A step by step approach to the ream and run is shown here. His early work with proximal humerus fractures provided him with the experience to use the same concepts to treat shoulder osteoarthritis oa. Since the popularization of shoulder hemiarthroplasty by neer in the 1950s, shoulder arthroplasty has been performed with increasing frequency, with more than 27,000 total shoulder arthroplasties tsas and 20,000 hemiarthroplasties has performed in the united states in 2008 alone. What are some of the indications of shoulder hemiarthroplasty. Physiotherapy before shoulder hemiarthroplasty surgery physiotherapy prior to shoulder hemiarthroplasty is a useful and recommended intervention. Surgical technique prepare acetabulum if acetabular reconstruction is required, prepare the acetabulum using the surgical technique for the intended acetabular component. Reverse arthroplasty is gaining in popularity, but hemiarthroplasty still has a role in the management of 4part and some 3part fractures and dislocations. Apr 19, 2011 one patient required early revision surgery. The actual post surgical physical therapy management must be based on the surgical approach, physical examfindings, individual progress, andor the presence of postoperative complications. The shoulder hemiarthroplasty is used to replace a humeral head that has been damaged by a fracture, a vascular necrosis of known or unknown cause, or a destructive tumor. Stepbystep, evidencebased guidance walks you through both common and unique cases youre likely to see in your practice, while. It features a true anatomical reconstruction of the joint, modular components, and is adaptable to a wide range of indications.
With modern cementing techniques, the rate of glenoid radiographic loosening is. Description a surgical procedure in which the humeral articular surface is replaced without attention to the glenoid side of the joint. It features a true anatomical reconstruction latitude total elbow prosthesis of the joint, modular components, and is adaptable to a wide range of indications. Hip hemiarthroplasty arizona, scottsdale hip fracture. Hemiarthroplasty was popularized by charles neer, md, 1 and represented a significant advance in shoulder arthroplasty. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Shoulder hemiarthroplasty for fractures of the proximal. It is not intended to be a substitute for special instructions from dr. Total shoulder arthroplastyhemiarthroplasty protocol. Whenever we question surgeons who routinely perform hemiarthroplasty instead of total shoulder arthroplasty for conditions such as primary osteoarthritis about why they chose not to resurface the glenoid, by far the most common response is that they encounter problems with glenoid exposure. Revision to reverse shoulder arthroplasty is a feasible option in properly selected patients.
Currently, surgeons debate the indications for and results of total. The jbjs has published a recent version of the technique here. Hemiarthroplasty is a technically easier and faster procedure than total. Suture technique and closure instrumentation the latitude surgical technique has been developed in conjunction with. Although most proximal humerus fractures can be treated nonoperatively, 4part fractures and 3part fracturesdislocations in elderly patients often require management with prosthetic arthroplasty. An incision is made along the outer aspect of the affected hip. Focusing on all key aspects of shoulder replacement surgery and emphasizing the latest techniques and tools, shoulder arthroplasty, 2nd edition, brings you expert procedural approaches from two master surgeons in the field. Hip hemiarthroplasty ventura ca hip surgery ventura. Surgical technique is a critical variable in the success of any arthroplasty. Revision shoulder arthroplasty is a complex procedure that requires precise planning. Based on the patients surgical procedure, other therapeutic exercises might be encouraged by. There are several conditions that can lead patients to consider shoulder joint replacement surgery.
It wasnt until neers work in the 1950s however that shoulder arthroplasty began to truly develop. Initial firstgeneration designs for total shoulder replacements were constrained, meaning the humeral and glenoid components were mechanically coupled around a fixed center of rotation. Not only will it help to reduce your current symptoms it will provide a solid platform for post surgical rehabilitation speeding up your rehab period and allowing you to maximise your rehab potential. Shoulder and elbow surgery a title in the operative techniques seriesoffers you the stepbystep guidance you needon slap reconstruction, total shoulder arthroplasty, humerus fractures, and morefrom experts donald lee and robert neviaser. Paff, or clinical decision making regarding the pro. Hemiarthroplasty for fracture neer type neer developed a foursegment classification system, which remains the standard for the evaluation and treatment of these injuries. Attempts to solve the glenoid problem with interposed. A displaced fragment is defined as one with displacement of more than 1 cm or angulation of more than 45 degrees fig. A hemiarthroplasty procedure results in less surgical time and less blood loss than a thr. Partial hip replacement also called hip hemiarthroplasty is a surgical technique employed to treat hip fractures. Problems with prosthetic glenoid components are loosening and wear. It covers followup exams, medication refills, and when to call your doctor or nurse.
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