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Surface Replacement The traditional shoulder replacement has a metal stem which is put down the inside of the humerus (Figure 1). Due to this stem there are potential problems associated with removal of the humeral head, component placement and problems related to the cement required to fix the replacement. For arthritis, only the surface of the joint is affected and thus Mr Stephen Copeland questioned the necessity for a stem The Copeland surface replacement was developed by Mr Copeland to avoid most of the difficulties and complications related to the traditional stemmed designs (Figure 2).
"For arthritis, there's absolutely no reason for using a stem
at all. It's got huge disadvantages because, if it does fail,
then getting it out can be real difficult and present many
problems," Copeland has said. If a revision is required, surface
replacement of the shoulder leaves the surgeon and patient at a
better starting point than does a stemmed humeral implant. "The
only bone you'd then remove would be the bone that you would
have removed the first time around using the stem prosthesis,"
Copeland said. So far thousands of patients have undergone the conservative shoulder surgery in more than 14 years. Approximately 50% of the cases had OA and the other half had rheumatoid arthritis or avascular necrosis. Mr L Funk trained under Mr Copeland as Shoulder Fellow, learning the procedure, as well as the minimally invasive approach (Mackenzie Approach). More Information:
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