Cementless Allograft-Prosthetic Composite Reconstruction Using an Interlocking Revision Stem for Salvage Reverse Total Shoulder Arthroplasty: A Case Report

Abstract

Proximal humerus fractures can present in many ways and have many treatment options. The Neer classification is used to describe fractures to help guide treatment. However, treatment is often surgeon-dependent due to the multitude of variables in the proximal humerus: whether it be the rotator cuff, important arteries supplying blood to the proximal humerus, or varying functional goals between patients. Surgical approaches may include fracture fixation, hemiarthroplasty, and reverse total shoulder arthroplasty. We present the case of a 55-year-old man who underwent salvage reverse total shoulder arthroplasty with allograft-prosthetic composite reconstruction for a proximal humerus fracture nonunion. The procedure was performed using a long revision stem with interlocking screws. The purpose of this implant is to enable restoration of appropriate length and rotation during reconstruction without the need for cement. The patient was lost to follow-up after his six-week postoperative visit, but demonstrated significant improvement in range of motion and function. However, more research needs to be done as to what the best approach is for proximal humerus reconstruction.