Copeland Shoulder: Advantages of Surface Replacement

1. Anatomical siting of head to allow for infinite variation of version, offset and angulation.
2. No intra-medullary reaming is required.  Therefore this is a less traumatic procedure in an elderly patient.  No risk of fat embolus or hypotension and no cement required.  There is no problem if the intra-medullary canal has already been previously violated with cement or stem from an elbow replacement from below.
3. If there is malunion at the proximal end of the humeral with secondary osteoarthritis, the malunion can be left undisturbed and just the humeral articular surface replaced.
4. If there is no stem extending down the humeral shaft and no stress riser effect and therefore no possibility of a low fracture at the tip of the prosthesis.

If the shoulder were to fail for any reason whatsoever, then no bone has been lost from the humeral head so all bone is preserved and saved for bone grafting (often the head is better following surface replacement than previously).  Therefore any revision surgery can be done, ie this can be changed for a stemmed type of prosthesis or an arthrodesis may be achieved easily as there is no lack of bone stock. There is no cement down the humeral shaft, none has to be removed and therefore this is an easy revision procedure.