allograft-prosthesis composite reconstruction of the proximal part of the humerus by ayesha abdeen,...

Allograft-Prosthesis Composite Reconstruction of the Proximal Part of the Humerus

by Ayesha Abdeen, and John H. Healey

JBJS Essent Surg TechVolume os-92(Supplement 1 Part 2):188-196

September 1, 2010

©2010 by The Journal of Bone and Joint Surgery, Inc.

A fresh-frozen osteoarticular graft: a = articular cartilage of humeral head, b = humeral shaft, c = anterior capsule of shoulder joint, d = subscapularis tendon, e = supraspinatus tendon, f =

deltoid insertion, g = pectoralis major tendon, and h = latissim...

Ayesha Abdeen, and John H. Healey J Bone Joint Surg Am 2010;os-92:188-196


The humeral head is osteotomized at the edge of the articular cartilage.



The custom-made stem.



The canal finder is inserted laterally.



The distal part of the host humerus is reamed in a line-to-line fashion.



The porous stem of the implant is covered with a latex-rubber digit cut from a surgical glove to shield the porous surface as the stem is inserted through the allograft filled with wet cement.



The implant is impacted in 35° to 40° of retroversion with respect to the forearm.



The shoulder is reduced and the soft tissues are repaired.



Soft-tissue reconstruction consists of suturing the host capsule to that of the allograft in a vest-over-pants fashion.



The remaining host deltoid tendon is often repaired to the remnant deltoid tendon of the allograft.



Anteroposterior radiograph showing the humerus and shoulder during postoperative internal rotation.



allograft-prosthesis composite reconstruction of the proximal part of the humerus by ayesha abdeen,...

Documents