About This Procedure
Shoulder pyrocarbon hemiarthroplasty is a joint-preserving partial replacement. Instead of resurfacing both sides of the joint, it replaces only the damaged ball — the humeral head — with a pyrocarbon implant, leaving your natural socket (glenoid) intact.
Pyrocarbon, or pyrolytic carbon, is a durable, biocompatible material whose stiffness is closer to that of natural bone than traditional metal. This bone-like behavior is intended to be gentler on the remaining socket cartilage and to wear slowly, which is why it is often considered for younger and more active patients.
Dr. Jay Levin offers pyrocarbon hemiarthroplasty at Duke Health facilities in Durham for carefully selected patients with shoulder arthritis or avascular necrosis who still have reasonable cartilage on the socket side and want to preserve their own bone for the future. Patients from Durham, Cary, Chapel Hill, and across North Carolina seek his care for joint-preserving shoulder options.
The Procedure
Pyrocarbon hemiarthroplasty is performed under nerve block and general anesthesia. Dr. Levin makes an incision along the front of the shoulder, carefully protecting the surrounding muscles and nerves — with particular attention to the subscapularis tendon.
The damaged humeral head is removed and replaced with a pyrocarbon ball component sized to your anatomy. Because the natural socket is preserved, no glenoid component is implanted. Dr. Levin uses advanced preoperative planning to optimize implant sizing and positioning.
Most patients go home the same day. Soft-tissue balancing ensures the shoulder moves smoothly and the repair is durable.
Recovery at Duke Health
Pyrocarbon hemiarthroplasty is routinely performed as an outpatient procedure at Duke Health, with most patients returning home the same day. The nerve block typically controls pain for 1–3 days; most patients need little or no opioids, and non-opioid medications such as Tylenol and Ibuprofen are routine.
Your arm will be in a sling for approximately 2 weeks, then gradually weaned. Early therapy is passive motion only and begins within the first week.
Do: Wear the sling as instructed. Perform your home exercise program as directed. Use your legs to push up from chairs.
Don't: Actively reach, lift, push, or pull early in recovery. Support your body weight through the operated arm before you are cleared.
Follow-up visits are typically scheduled at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and yearly thereafter. Dr. Levin provides close follow-up to monitor healing and guide your rehabilitation.
Risks
As with any surgery, pyrocarbon hemiarthroplasty carries risks, including infection, bleeding, nerve or vessel injury, stiffness, subscapularis failure, progressive socket-side wear that may require future surgery, implant loosening, and fracture. Dr. Levin discusses these and any patient-specific concerns during your consultation.
Dental Care
Per AAOS/ADA guidelines, antibiotics are generally not required before dental procedures. Avoid non-urgent dental work for 3 months after surgery.