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Endoscopically guided subchondral intraosseous osteotomy and bone graft stabilization for osteonecrosis of the humeral head.
Osteonecrosis of the humeral head can be viewed as a disease with a variety of pathologic presentations likely to require surgical intervention. Although occurring less frequently than osteonecrosis of the femoral head, the goals of treatment are relief of pain, maintenance of shoulder joint congruency and range of motion, and delay or prevention of total or hemi shoulder arthroplasty. The ideal treatment for early stages will preserve the natural humeral head, with the chosen treatment modality being influenced by the age of the patient and the stage of disease with an emphasis on the presence and degree of collapse, as well as the size and location of the lesion.

Variable success rates (range, 33% to 95%), depending on the stage of disease, have been achieved with core decompression of the femoral head, under the guise that the procedure decreases intraosseous pressure and improves intraosseous circulation. Whereas extrapolation of clinical data from the hip to the shoulder may be common, treatment options for early stage disease in the shoulder are limited. However, with continued clinical success using an endoscopically guided approach to ensure thorough debridement of the femoral head, OSI proudly presents an identical approach for the humeral head.

The endoscopically guided approach used with the Titanium TSY™ Shoulder Plate Bone Graft Stabilization System (BGSS) is specifically designed to assist those surgeons who determine that thorough debridement and nonvascularized bone-grafting is the best treatment modality for a given patient. The endoscopic approach enhances the surgeon’s ability to identify and debride necrotic bone within the humeral head while minimizing the soft-tissue dissection. The Titanium TSY™ Shoulder Plate stabilizes the fresh autologous cancellous bone and bone marrow placed into the humeral head (preventing its micromotion) thereby assisting its incorporation into the surrounding host bone through primary bone healing.

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