Categorised under:
Orthopaedics
>
Upper limb
>
Shoulder resurfacing/short stem
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Comments
Comment by Commented Nov 18, 2014
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Comment by djcloke Commented Oct 26, 2010
Impact factor: 34
User Rating
Overall, the published evidence shows good results from Copeland resurfacing, and I think resurfacing has a particular role in young active patients, and it is then that I consider resurfacing hemiarthroplasty rather than TSR. However, I am not entirely convinced that resurfacing hemiarthroplasty with a 6mm thick implant in a worn humeral head and glenoid will restore biomechanics, and is suggested.
Although I used the Copeland system as a trainee and fellow, I have moved to another system as a consultant. The main reasons for this are that the sizing system for the Copeland, whilst comprehensive, is a little counter-intuitive. A central wire is passed using a guide that gives some idea of head size, but the choice of reamer and implant is based on "best fit" rather than measurement. Also, whilst numbered, the reamers and implants are non-sequential, a factor that is often overlooked.
Otherwise, once the size is selected, the head is reamed with a simple hemispherical reamer and then the central hole is drilled. It is possible them to go back and ream more bone using an adapter in the central hole to essentially override the stop on the reamer. In other systems, however, one reamer is used for these functions which eliminates a step.
The Copeland system certainly has the evidence behind it, more than similar systems, but I personally prefer a system that allows me to select and implant by measurement rather than best fit.