Proximal ingrowth coating decreases risk of loosening following uncemented shoulder arthroplasty using mini-stem humeral components and lesser tuberosity osteotomy

Morwood, Michael P.; Johnston, Peter S.; Garrigues, Grant E.

doi:10.1016/j.jse.2016.11.041

Cited by 58 publications

(41 citation statements)

References 29 publications

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“…In 2000 Sperling et al [ 8 ] defined humeral components as “at risk” when there was radiographic evidence of subsidence, tilt, or 2 mm radiolucent lines around the implant following primary (regular long stem) implantation of TSAs. Between 2015 and 2018, several studies evaluated radiographic results after TSA with an uncemented short stem prosthesis [ 26 , 27 , 34 , 35 , 36 ]. Only in two studies, small numbers of subsidence were found, but the extent of the inferior migration was not expressed numerically [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…Between 2015 and 2018, several studies evaluated radiographic results after TSA with an uncemented short stem prosthesis [ 26 , 27 , 34 , 35 , 36 ]. Only in two studies, small numbers of subsidence were found, but the extent of the inferior migration was not expressed numerically [ 34 , 35 ]. In 2016, Morwood et al [ 35 ] analyzed the effect of proximal porous coating on a mini-stem humeral component in 68 shoulders with glenohumeral osteoarthritis, proximal humeral fracture sequelae, avascular necrosis of the humeral head, or instability arthropathy.…”

Section: Discussionmentioning

confidence: 99%

“…Only in two studies, small numbers of subsidence were found, but the extent of the inferior migration was not expressed numerically [ 34 , 35 ]. In 2016, Morwood et al [ 35 ] analyzed the effect of proximal porous coating on a mini-stem humeral component in 68 shoulders with glenohumeral osteoarthritis, proximal humeral fracture sequelae, avascular necrosis of the humeral head, or instability arthropathy. After a two-year follow-up of 34 coated stems, no stem loosened, but one showed subsidence and seven developed radiolucency.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study

Tross

Lädermann

Wittmann³

et al. 2020

JCM

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Background: The radiological phenomenon of subsidence following the implantation of uncemented short-stem reverse prostheses (USSP) has not yet been described. The purpose of this study was to describe the rate and potential risk factors for subsidence. We hypothesized that subsidence may be a frequent finding and that a subsidence of >5 mm (mm) is associated with an inferior clinical outcome. Methods: A total of 139 patients with an average age of 73 ± 9 years were included. The clinical and radiological outcome was evaluated at a minimum follow-up (FU) of 12 months. Results: No humeral component loosening was present at a mean FU of 18 (range, 12–51) months. Mean Constant Score (CS) and Subjective Shoulder Value (SSV) improved significantly from 34.3 ± 18.0 points and 37.0 ± 19.5% preoperatively to 72.2 ± 13.4 points and 80.3 ± 16.5% at final FU (p < 0.001). The average subsidence of the USSP was 1.4 ± 3.7 mm. Subsidence of >5 mm was present in 15 patients (11%). No association between a subsidence >5 mm and CS or SSV was found (p = 0.456, p = 0.527). However, a subsidence of >5 mm resulted in lower strength at final FU (p = 0.022). Complications occurred in six cases (4.2%), and the revision rate was 3.5% (five cases). Conclusions: Although subsidence of USSP is a frequent radiographic finding it is not associated with loosening of the component or a decrease in the clinical outcome at short term FU. Level of evidence: Level 4, retrospective study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study

Tross

Lädermann

Wittmann³

et al. 2020

JCM

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“…The clinical results of a part of this patient cohort (n = 65) were published by Schnetzke et al in a separate study [26]. In the studies by Morwood et al [15] and Szerlip et al [29] the outcome of the AM and the AF was compared. Denard and coworkers [9] did not differentiate between shoulders treated with AM or AF.…”

Section: Demographicsmentioning

confidence: 99%

Short-stem anatomical shoulder replacement—a systematic review

Schnetzke

Loew²,

Raiss³

et al. 2019

Obere Extremität

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“…The prosthetic implants used in this study were an earlier version without proximal porous coating. In a later study, Morwood et al 18) who used an upgraded version of the Aquelis Ascend system to compare stems with proximal porous coating (n=34) and those without (n=34) found that stem loosening was not observed in any patients and radiolucency was observed in 7 patients (20.6%) in the former group whilst there were 1 case (2.9%) of aseptic loosening, 7 cases of (20.6%) at risk of loosening, and 15 cases (44.1%) of radiolucency in the latter group. Therefore, their report suggested that proximal porous coating in short-stem humeral components can lower stemrelated complications.…”

Section: ) Arthrexmentioning

confidence: 87%

Short Humeral Stems in Shoulder Arthroplasty

Lim

2018

Clin Shoulder Elbow

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Since the introduction of shoulder arthroplasty by Neer in 1974, the design of not only the glenoid component but also the humeral component used in shoulder arthroplasty has continually evolved. Changes to the design of the humeral component include a gradually disappearing proximal fin; diversified surface finishes (such as smooth, grit-blasted, and porous coating); a more contoured stem from the originally straight and cylindrical shape; and the use of press-fit uncemented fixation as opposed to cemented fixation. Despite the evolution of the humeral component for shoulder arthroplasty, however, stem-related complications are not uncommon. Examples of stem-related complications include intraoperative humeral fractures, stem loosening, periprosthetic fractures, and stress shielding. These become much more common in revision arthroplasty, where patients are associated with further complications such as surgical difficulty in extracting the humeral component, proximal metaphyseal bone loss due to stress shielding, intraoperative humeral shaft fractures, and incomplete cement removal. Physicians have made many attempts to reduce these complications by shortening the stem of the humeral component. In this review, we will discuss some of the limitations of long-stem humeral components, the feasibility of replacing them with short-stem humeral components, and the clinical outcomes associated with short-stemmed humeral components in shoulder arthroplasty.

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Proximal ingrowth coating decreases risk of loosening following uncemented shoulder arthroplasty using mini-stem humeral components and lesser tuberosity osteotomy

Cited by 58 publications

References 29 publications

Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study

Subsidence of Uncemented Short Stems in Reverse Shoulder Arthroplasty—A Multicenter Study

Short-stem anatomical shoulder replacement—a systematic review

Short Humeral Stems in Shoulder Arthroplasty

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