More than Ten Years’ Experience with Unconstrained Shoulder Replacement

Abstract

The shoulder joint has been given relatively little attention compared with the joints of the lower extremity. Diseases of the shoulder joint are more readily accessible to treatment by conservative means. Joint-salvaging procedures such as synovectomy, the various types of osteotomy, and resection arthroplasties have specific and limited indications [1]. In the past, shoulder replacement has been used only in patients with severe destruction of the bone. Frequently the damage also involves the musculotendinous cuffs and the deltoid, especially after multiple operations. It is common in these cases for severe pain to coexist with irreversible losses of function. The implants that are used in the reconstruction of osteoarthritic shoulders may be one of three types [4]:

• 1) noninterlocking systems with incongruent articular surfaces (unconstrained type),

• 2) noninterlocking systems with congruent articular surfaces (semiconstrained type),

• 3) interlocking prostheses with congruent articular surfaces (constrained type).