Humeral technique in total shoulder arthroplasty.

Humeral head replacement arthroplasty has been performed for more than 40 years. As the technique has been refined and advances have been made in joint arthroplasty of the lower extremity, the indications and success of shoulder arthroplasty have greatly improved. The humeral component in a shoulder arthroplasty can be implanted with either cement or press fit fixation. Both techniques are precise and demand meticulous attention to detail to achieve optimum results for the patient. Press fit fixation, with or without porous coating for biologic ingrowth, can be considered for a patient with good bone stock, if it is felt that a stable interface can be obtained. In patients with abnormal bone, such as those with rheumatoid arthritis who are on corticosteroids and those with osteoporosis, the use of cement can provide stable long-term fixation.