Are short press-fit stems comparable to standard-length cemented stems in reverse shoulder arthroplasty? A prospective, randomized clinical trial

Reverse Total Shoulder Arthroplasty with a Cementless and Metaphyseal Stem Fixation Is a Viable Option for the Treatment of Proximal Humeral Fractures with Calcar Involvement

“…In this scenario, the cemented stem fixation could be considered since a strong primary stability is provided with less rotational micromotion than the press-fit fixation but equivalent axial micromotion [ 31 ]. Accordingly, the press-fit stems may be potentially more prone to translation than the cemented stems, despite the evolution in the stem’s design and materials with the addition of the proximal porous coating for bone ingrowth [ 32 ]. As observed by a recent radiostereometric study, short press-fit stems are exposed to a potential mean translation of 0.6 mm more than the standard-length cemented stems at two-years follow-up, albeit not associated to any evidence of stem loosening or consequences on clinical outcomes [ 32 ].…”

“…The present study has some limitations, including the retrospective design, the relatively small sample size, and the follow-up period of five years. As a matter of fact, this follow-up might be acceptable to detect the most severe complications since the greatest amount of implant translation and subsidence is observed within first year postoperatively [ 32 ]. However, a longer follow-up is certainly advocated in order to reveal radiographic complications not yet clearly evident.…”

Shoulder & Elbow

“…In their paired papers, a team from London (Canada) reported on their randomized controlled trial assessing implant fixation and patientreported outcomes following reverse shoulder arthroplasty. 2 They employed an efficient 2×2 factorial design to make two comparisons:…”

“…In their paired papers, a team from London (Canada) reported on their randomized controlled trial assessing implant fixation and patient-reported outcomes following reverse shoulder arthroplasty. 2 They employed an efficient 2×2 factorial design to make two comparisons: 1) standard length cemented humeral stem versus shorter press-fit humeral stem; and 2) bony increased offset (BIO) glenoid fixation with a 10 mm humeral head autograft over a long-post implant with peripheral screws versus wedge augmented porous metal glenoid baseplate with central and peripheral screws. The results were analyzed as two independent studies, with additional testing for interaction effects; the second of these comparisons is addressed in the next section of BJ360 .…”

What’s New in Shoulder and Elbow Surgery

“…No significant differences were found between groups at the 2-year follow-up with regard to the Constant score, scapular notching, and complications. Van de Kleut et al 22 compared clinical outcomes and humeral implant migration between standard-length cemented stems (n = 19) and press-fit short stems (n = 17) using model-based radiostereometric analysis on sequential radiographs in a 2-year follow-up. Press-fit short stems migrated significantly more inferiorly at 6 months and 1 and 2 years, consistent with subsidence, and had greater total mean translation at 2 years (1.0 ± 1.1 mm) compared with cemented standard stems (0.4 ± 0.2 mm), but the mean migration between 1 and 2 years was minimal for both groups.…”