Cemented or cementless humeral fixation in reverse total shoulder arthroplasty?

Phadnis, Joideep; Huang, Tianlong; Watts, AC; Krishnan, Jeganath; Bain, Gregory I.

doi:10.1302/0301-620x.98b1.36336

Cited by 74 publications

(30 citation statements)

References 51 publications

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“…22 Furthermore, two recent studies showed that uncemented humeral stems have equivalent clinical and radiographic outcome compared to cemented stems in the shortand midterm, but have the advantages of shorter operation time, better biological ingrowth potential and easier to revise when necessary. 9,23 In our longterm followup study only one humeral stem was revised.…”

Section: Discussionmentioning

confidence: 92%

Long – Term survivorship and clinical and radiological follow – up of the primary uncemented Delta III reverse shoulder prosthesis

Ochten¹,

Pluijm

Pouw

et al. 2019

Journal of Orthopaedics

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Background: Purpose of this study was to evaluate the longterm survivorship and clinical and radiological results of a primary reverse total shoulder arthroplasty (RTSA) performed with uncemented stems. Methods: From 2001 until 2006 61 primary uncemented RTSAs were implanted, which were included in a Kaplan-Meier survival analysis. Range of motion, functional scores and radiological followup was obtained. 27 patients were available for followup. Mean follow-up was 9.2 years (SD 2.4). Results: Mean cumulative survival was 82.4% (95% CI: 50.7-94.6%) of the total construct and 98.3% (CI: 88.8-98.8%) of the uncemented humeral stem after 12.5 years. Five revisions occurred (8.2%). Mean anteflexion improved from 69.3 to 111.9°(p < 0.0001), lateral elevation from 65.9 to 101.3°(p < 0.0001), Constant-Murley score from 39.1 to 66.9 (p < 0.0001), Simple Shoulder Test from 1.5 to 7.1 (p < 0.0001), and VASpain from 65.5 to 6.6 at final follow-up (p = 0.0003). Scapular notching was present in 94.1% of the patients. Conclusions: The present study shows that the long-term clinical results of the primary Delta III RTSA seem very encouraging and survivorship of, in particular, its uncemented humeral stem is good.

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Section: Discussionmentioning

confidence: 92%

Long – Term survivorship and clinical and radiological follow – up of the primary uncemented Delta III reverse shoulder prosthesis

Ochten¹,

Pluijm

Pouw

et al. 2019

Journal of Orthopaedics

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“…22 The results reported here confirm that the short-term clinical outcomes at an average 3 years of follow-up is comparable with those obtained with the Grammont design. 5,6,9,10,12,15,[17][18][19][22][23][24][25][26][27] This stem still requires longer term follow-up to confirm these initial findings. Interestingly, internal rotation appears improved with the short-stem press-fit component compared to the Grammont design.…”

Section: Discussionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results

Ascione

Bugelli

Dömös

et al. 2017

Journal of Shoulder and Elbow Arthroplasty

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Background: The Grammont-style reverse shoulder arthroplasty (RSA) has demonstrated complications intrinsic to its design such as tuberosity fracture and scapular notching. A new short-stem press-fit humeral component with an onlay tray has been devised to avert these issues. We hypothesize that the clinical outcomes and rates of humeral complications of this new stem will be comparable to those of the traditional Grammont design and the lateralization obtained from the stem's lower neck-shaft angle will decrease the rate of notching without creating instability. Methods: We retrospectively evaluated 100 patients who underwent RSA with an onlay short-stem humeral component with a minimum follow-up of 2 years. Clinical outcomes as well as standard radiological examinations were documented preand postoperatively. Several correlations were analyzed. Results: At mean 32.6-month follow-up, the cohort demonstrated a significant improvement in several outcomes: Constant score increased from 25.5 to 69.7 points, mean anterior elevation increased from 82.1 to 141.9 , external rotation from 5.6 to 25.1 , and internal rotation from sacrum to the L3 vertebral level. There was a 30% rate of stem malalignment and 37% rate of scapular notching, not associated with any adverse clinical outcomes. The overall rate of complications was 15%, of which scapular fractures were most common (5%). Conclusion: Our short-term results suggest that the clinical outcomes and rates of humeral complications are similar to those reported for the Grammont RSA, demonstrating less scapular notching, but increased scapular stress fractures and potential subsidence of the prosthesis due to the metaphyseal press-fit require further investigations.

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“…[11][12][13][14][15][16] Loosening of the prosthetic components can cause pain and loss of function, although aseptic loosening is rare during the initial postoperative years. [17][18][19][20] Location of the pain can guide the surgeon in the diagnosing process. Thus, pain in the proximal part of the upper arm can indicate humeral loosening, spontaneous periprosthetic fracture or infection; pain over the scapula can indicate a fracture of the spine of scapula or suprascapular nerve irritation by the superior screw of the glenoid component.…”

Section: Analysis and Aetiology Of Painmentioning

confidence: 99%

Management of painful reverse shoulder arthroplasty

Ekelund

2017

Shoulder & Elbow

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Even though reverse shoulder arthroplasty is a very successful procedure, painful complications occur. During the initial postoperative years, the most common reasons for pain are instability, postoperative fracture of the acromion or spine, and periprosthetic infection. Later, aseptic loosening, with humeral loosening being more frequent that glenoid loosening, can be a source of pain and reduction in function. A careful patient history, clinical examination, plain radiographs, computed tomography and blood tests give an explanation for the pain in most cases. The majority of these complications can be successfully treated, maintaining a functional reverse shoulder arthroplasty. However, if all examinations are normal, it is important to remember that nonshoulder conditions such as tumour of the lung or degenerative changes of the cervical spine can give shoulder pain.

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Cemented or cementless humeral fixation in reverse total shoulder arthroplasty?

Abstract: This study demonstrates that uncemented stems have at least equivalent clinical and radiographic outcomes compared with cemented stems when used for reverse total shoulder arthroplasty.

Cited by 74 publications

References 51 publications

Long – Term survivorship and clinical and radiological follow – up of the primary uncemented Delta III reverse shoulder prosthesis

Long – Term survivorship and clinical and radiological follow – up of the primary uncemented Delta III reverse shoulder prosthesis

Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results

Management of painful reverse shoulder arthroplasty

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