Name:
Eclipse Stemless Shoulder Replacement
Description:
Eclipse Stemless Shoulder Replacement
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/a6f75d04-2096-4f06-bf82-49872a5578fa/videoscrubberimages/Scrubber_1.jpg
Duration:
T00H09M24S
Embed URL:
https://stream.cadmore.media/player/a6f75d04-2096-4f06-bf82-49872a5578fa
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/a6f75d04-2096-4f06-bf82-49872a5578fa/Eclipse Stemless Shoulder Replacement.mp4?sv=2019-02-02&sr=c&sig=0hwO6F8bYG5r069t4YNufI5C1FAlFa52nMCZuSnXOs8%3D&st=2024-11-24T04%3A10%3A16Z&se=2024-11-24T06%3A15%3A16Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Shoulder hemiarthroplasty using the Arthrex eclipse stemless system. The patient is placed in the beach chair position and a deltopectoral incision made just lateral to the coracoid. The incision is developed to identify the cephalic vein, which is mobilized to reveal the conjoint tendon.
The tendon is released from any adhesions and mobilized medially to expose the subscapularis. The long head of biceps is identified and traced to locate the rotator interval. The interval is incised, which enables the subscapularis tendon to be reflected off the lesser tuberosity.
This release is continued down to the bottom of the tendon and then progressed medially to reflect the whole tendon away from the capsule. Once a full release has been undertaken,
it is possible to insert retractors between the humeral head and the glenoid to start to deliver the humeral head. At this stage, further inferior releases can be undertaken to ensure that the whole of the humeral head and the neck of the glenoid are free. In this situation, the humeral head is very degenerate as the primary diagnosis was avascular necrosis.
Osteophytes and loose fragments are removed to expose the true shape of the humeral head. The correct size and side of cutting jig are selected. The jig is aligned with the long axis of the humerus and with the forearm using the version alignment rods.
The guide pins are inserted through the jig. These will form the platform when the humeral cut is made.
Once they are secure, the jig is removed. In this case, because of the destruction of the humeral head, the lower pin was not helpful and was removed as well, With the guide pins as reference, an oscillating saw is used to cut the humeral head. In this situation, the avascular necrosis has left a very little head to be excised.
The trial humoral implant is then used to determine the appropriate size. The jig is then placed in position and secured with a few taps of a mallet.
A shallow corer is used to make a small pilot groove within the jig. This does not remove any bone, but creates a pilot hole for the insertion of the centralizing peg. The peg is seated and secured with a few taps of a mallet.
To measure the depth for the cage screw the guide pin is inserted and tapped down until it reaches the far cortex. The depth is read off the mark adjacent to the centralizing peg. The guide pin and the initial jig are removed, leaving the centralizing peg in situ.
If the glenoid is going to be addressed, the centralizing peg can be removed and a protecting plate inserted. With the centralizing peg back in position, the definitive implants can be inserted. The trunnion is sized from the initial jig. This is placed over the centralizing peg and seated with a few taps of a mallet.
The centralizing peg is then removed in preparation for the insertion of the cage screw. The cage screw is loaded onto a screwdriver and introduced into the face of the trunnion. Care must be taken not to rock the trunnion as the screw is inserted.
It is also essential that the screw does not engage on the far cortex as this will prevent it from applying compression to the trunnion. Once the cage screw is fully seated, the screwdriver can be removed.
The taper is then prepared for the insertion of the humeral head. The head size matches the trunnion size and is placed on the taper. It is secured with a few taps of a mallet.
Once seated, the instruments can be removed and the head reduced. Stability is then checked. Subscapularis is repaired. In this case, the sutures pass through the prepared decorticated surface of the lesser tuberosity and through the lateral stump.
Once several sutures have been passed, they are tied down sequentially, securing the subscapularis. The security of the repair can then be checked by externally rotating the arm. The skin is then closed using a standard absorbable subcuticular suture.
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