Revision of humeral components in shoulder arthroplasty

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 component in shoulder arthroplasty. Revision of the stem can be easy with a non-infected platform stem only requiring exchange of the epiphyseal component. Some stems, usually uncemented, can readily be removed from a proximal only approach. Stems with excellent cement mantles may require a longitudinal only split in the humerus done with minimal stripping of the brachialis. If complete cement removal is needed for infection or there is distal stem on growth, then a vascularized door technique is indicated. These techniques are explained in detail in this manuscript.