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Report of Results After Compaction Bone-Grafting in Shoulder Replacements

When large joints like the shoulder are replaced with implants, surgeons try to avoid using cement to hold the implant in place. Cement works well, but problems can develop later. If the implant must be revised or removed for any reason, more bone is lost scraping the remaining cement out.

This is the first study to report the results of using compaction bone-grafting as a fixation method for total shoulder arthroplasty (TSA). Arthroplasty is another word for joint replacement.

Compaction bone-grafting takes the round head of the humerus (upper arm bone) after it is removed and breaks it down into tiny pieces. The pieces are referred to as morselized bone.

The humeral implant is placed down inside the open canal of the humerus. The graft material is put around the implant. The implant is used to tamp or compact the bone in place. The surgeon knows that there is enough bone graft in place when the implant can no longer be pulled out or twisted inside the canal.

Patients with poor bone quality were chosen for this procedure. If the surgeon put the implant down into the bone and could still wiggle it from side to side, compaction bone-grafting was used. Likewise, if the implant slid down into the bone too easily, then this fixation method was applied. Fifty-eight shoulders were treated with compaction bone-grafting.

Results were measured over a five-year period of time. Pain, shoulder comfort, function, and quality of life were used to gauge the success of this method. X-rays were taken to assess the position of the implant and quality of the bone.

References: Michael A. Wirth, MD, et al. Compaction Bone-Grafting in Prosthetic Shoulder Arthroplasty. In The Journal of Bone and Joint Surgery. January 2007. Vol. 89-A. No. 1. Pp. 49-57.

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