Arthroplasty in Post-traumatic Arthritis

Surgery for shoulders with arthritis after and injury, fracture or previous surgery can lessen shoulder pain and improve function with a special type of joint replacement

Last Updated: March 27, 2011

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The basic principles of shoulder arthroplasty in post traumatic arthritis are similar to those in degenerative arthritis but some important differences exist because of scarring and deformity.

Scarring and deformity

The anatomy is likely to be distorted by previous fracture and surgery. The nonarticular humeroscapular motion interface is likely to be scarred obscuring important neurologic structures such as the axillary nerve. The tuberosities the humeral shaft and the glenoid may be ununited or malunited.

Restoring normal anatomical relationships

As a first step the humeroscapular motion interface must be carefully freed and the axillary nerve identified both as it crosses the subscapularis and as it courses laterally on the deep surface of the deltoid.

Case by case judgments must be made concerning the need for osteotomy to try to restore more normal anatomic relationships recognizing that additional healing and postoperative protection may be required. Again the goal is restoration of anatomic relationships firm fixation of components soft tissue balance stability and smooth gliding in the nonarticular humeroscapular motion interface.

Click to enlarge

Figure 1 - Humeroscapular
motion interface
Click to enlarge

Figure 2 - Deep surface
of the deltoid

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