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Chapter 10 Video 1: Revision Shoulder Arthroplasty: Hemi- to Total Shoulder Arthroplasty Conversion

January 05, 2018

Contributors: William N Levine, MD; Charles Mitchell Jobin, MD; Brian Shiu, MD

This video demonstrates the revision of a hemiarthroplasty to a total shoulder arthroplasty. The previous deltopectoral approach incision is utilized. A lesser tuberosity osteotomy is performed to avoid repeat takedown of the subscapularis tendon. A head extractor is used to remove the previous implant. The glenoid, which has not previously instrumented, is then exposed. The glenoid is prepared and care is taken to avoid superior tilt and inferior positioning on the glenoid. The appropriate glenoid implant size is chosen and peg preparation performed, followed by pulsed irrigation, and cement pressurization. The humeral head is trialed, then the implant is placed. The lesser tuberosity osteotomy is repaired with sutures passed around the humerus with the secure fixation demonstrating no displacement through a range of motion.

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