Revision of a shoulder arthroplasty often requires removal of a well fixed humeral component. Revision of this component can be quite easy in the case of a non-infected platform stem or be very difficult when removal of a well cemented or on-growth stem with distal texturing is required. The purpose of this paper is to provide a series of techniques designed for revision of the humeral componen...

Since wear and loosening of the ultra-high-molecular-weight polyethylene cup are factors which limit the life of an arthroplasty we have attempted to identify factors associated with either low wear (0.02 mm/year or less) or high wear (0.2 mm/year or more). In a series of 1434 Charnley low-friction arthroplasties (1092 patients) 190 (13.2%) showed low wear while 149 (10.4%) showed high wear. We...

A retrospective review of 72 cases of Charnley low friction arthroplasty revised for stem loosening, has identified a number of "at risk" factors. These were: previous hip surgery and, in radiographs taken at one year, demarcation of the distal cement and fracture of the cement near the tip of the stem. Separation of the back of the stem from the cement, as an isolated feature, was not consider...

Introduction: Isolated stem fractures have been reported for total elbow replacements (TER) and are most frequently associated with 1) younger patients with high activity levels and 2) poor boney support conditions associated with post-traumatic arthritis [1-4]. No international test standards exist to evaluate fatigue strength of humeral and ulnar stems of a TER. Therefore, a test method was d...

Early failures have seen titanium fall from favour as a material for cemented femoral stems. Between 1989 and 1994, we performed a prospective review of a consecutive series of 122 cemented total hip replacements using the Ultima straight textured titanium stem, and report the fiveto ten-year clinical and radiological outcomes. There were no revisions for loosening of the femoral stem. Revision...

HYPOTHESIS Revision shoulder arthroplasty represents a complex and difficult problem for the treating surgeon, with multiple potential complications. In the setting of a well-fixed humeral component, removal can lead to fractures and compromise the outcome of the revision. The current study describes and evaluates the results of a novel vertical humeral osteotomy (VHO) for stem extraction. We h...

BACKGROUND There has been controversy whether methylmethacrylate precoating of the cemented femoral stem is a solution for aseptic loosening or rather contributes to increased failure rates in cemented total hip arthroplasties. METHODS On a retrospective basis, we analyzed 76 primary hybrid total hip arthroplasties from 63 patients with precoated, cemented femoral stems between October 1990 a...

BACKGROUND Revision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss. Newer modular systems allow conversion from anatomic to reverse shoulder arthroplasty with retention of a well-fixed humeral stem. We report on a prospectively evaluated series of conversions from hemiarthroplasty to reverse shoulder arthroplasty...

Metallosis after shoulder replacement has not previously been described in the literature. We report a patient who developed extensive metallosis after implantation of an uncemented Nottingham shoulder replacement. He underwent a revision procedure. Examination of the retrieved prosthesis showed that the titanium porous coating was separating from the humeral stem and becoming embedded in the u...