Abstract
Techniques for placement and fixation of the humeral component in shoulder arthroplasty have evolved over the past 40 years. This article reviews the comparative advantages and disadvantages of three commonly used methods for humeral prosthetic fixation (porous in-growth, classic press-fit, and cementing) and compares them with our presented technique of conservative broaching and impaction grafting. In this presented method, morcellized cancellous bone from the resected humeral head is sequentially impacted into the metaphyseal and proximal diaphyseal regions of the proximal humerus. This graft serves to 1) fill voids between implant and bone to improve fixation, 2) preserve bone stock, 3) allow for optimization of implant position, 4) minimize the risk of fracture compared with the conventional press-fitting technique, and 5) minimize the need for complex prosthesis modularity.
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