Humeral bone grafting in stemless shoulder arthroplasty

Stemless shoulder arthroplasty with metaphyseal fixation of the humeral component is increasingly used in the treatment of primary or secondary osteoarthritis, achieving significant pain relief and improving both range of motion and patient satisfaction [1, 4, 6]. The majoradvantagesof the stemlesshumeral design are preservation of humeral bone stock, anatomical reconstruction regardless of humeral malalignment, fewer stem-related complications, and ease of revision [2]. Hawi et al. recently showed good long-term clinical and radiological outcomes with a revision rate of approximately 7% without humeral implantrelated complications [6]. Currently, poor bone quality, including osteoporosis or metaphyseal cystic changes, is described to be a contraindication for stemless shoulder prostheses [5]. Thus, it is generally recommended to switch to a stemmed prosthesis to provide bone ingrowth and primary stability. The purpose of the following technique is to embrace the advantages of the stemless design when treating severe primary or secondary osteoarthritis, even in the presence of a large humeral bone defect, using the Eclipse prosthesis (Arthrex, Naples, FL, USA) combined with a humeral autograft (. Fig. 1a–d). Technical note