Humeral Windows, Osteotomies, and Episiotomies
As the rate of shoulder arthroplasty increases, the demand of revision surgery will continue to rise. Despite not being a major cause of revision surgery, the humeral stem is often addressed in revision arthroplasty. A major complication of removal of both loose and well-fixed humeral prosthesis is fracture. Two major techniques have been developed to help extract a humeral prosthesis. Humeral osteotomy or episiotomy is a unicortical cut into the bone and cement to disrupt the hoop stresses that stabilize the implant. Humeral windows are larger osteotomies of the cortex that provide greater access to the stem or cement mantle but have shown to still have higher intraoperative fracture rates. Both techniques have their respective advantages and disadvantages, but both are reliable methods to extract a humeral prosthesis safely with good clinical outcomes and minimal loosening of the subsequently implanted prosthesis. This chapter will highlight the key technical steps and pearls to allow successful revision of a humeral stem.
KeywordsRevision arthroplasty Humerus Osteotomy Window
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