This is an interesting case of a middle aged patient who was seen in the office because of shoulder pain for the past 5 years. The patient had 15 years ago an anatomic shoulder replacement. Radiographic evaluation demonstrated well fixed press fit stemmed anatomic shoulder arthroplasty - implant that is not available in the US market anymore - and fractured glenoid with posterior displacement of the all poly glenoid component. There was no clinical signs of infection and the patient was keeping the arm in a sling for the past several years for comfort. Due to the young age of the patient and the history of multiple falls a decision was made to revise the implant to a smaller size humeral head hemiarthroplasty and avoid implantation of a reverse shoulder arthroplasty.
During surgery the keeled glenoid component was found loose, with loose cement, there was metallosis and 50 % of the posterior glenoid bone was deficient with a step off of 5 mm.
The purpose of the revision was to provide a less painful prosthetic implant that will allow the patient to use the wheelchair which is necessary to this patient for transportation.
