Gregory Gilot1, Andres M Alvarez-Pinzon2, Thomas W Wright3, Pierre-Henri Flurin4, Michael Krill1, Howard D Routman5, Joseph D Zuckerman6. 1. Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA. 2. Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA. Electronic address: mauricioalvarez07@yahoo.com. 3. Department of Orthopaedic Surgery, University of Florida, Gainesville, FL, USA. 4. Department of Orthopaedic Surgery, Clinique du Sport de Bordeaux-Mérignac, Mérignac, France. 5. Department of Orthopaedic Surgery, Palm Beach Shoulder Service, Palm Beach, FL, USA. 6. Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, NY, USA.
Abstract
BACKGROUND: The reverse total shoulder arthroplasty (RTSA) has been used in the treatment of complex shoulder problems. The incidence of aseptic loosening of the humeral component has not been previously reported. METHODS: This is a multicenter, retrospective, blinded, case-control radiographic review of 292 patients to determine the rate of humeral stem loosening. There were 177 cemented and 115 press-fit humeral components. Radiographs were critiqued for radiolucent lines adjacent to the humeral stem based on the method described by Gruen et al. RESULTS: The overall rate of loosening was 0.74%. No radiographic loosening occurred in the press-fit group (115 stems). In the cemented group (177 stems), 2 shoulders (1.18%) were identified with radiographically loose stems. No loosening occurred in the press-fit group. No statistically significant difference was found in humeral stem loosening when the press-fit group and the cemented group were compared (P = .198). DISCUSSION: Our study indicates the cemented or press-fit RTSA system will result in a low incidence of radiolucent lines and radiographic loosening. Compared with historical survivorship of conventional anatomic total shoulder arthroplasty, RTSA shows a lower rate of radiographic stem loosening at a mean of 38.46 months. CONCLUSIONS: The RTSA has a low incidence of humeral stem loosening at midterm. These results underscore the importance of careful selection of patients to provide the benefits of this surgical technique. Press-fit fixation may provide a lower risk to stem loosening.
BACKGROUND: The reverse total shoulder arthroplasty (RTSA) has been used in the treatment of complex shoulder problems. The incidence of aseptic loosening of the humeral component has not been previously reported. METHODS: This is a multicenter, retrospective, blinded, case-control radiographic review of 292 patients to determine the rate of humeral stem loosening. There were 177 cemented and 115 press-fit humeral components. Radiographs were critiqued for radiolucent lines adjacent to the humeral stem based on the method described by Gruen et al. RESULTS: The overall rate of loosening was 0.74%. No radiographic loosening occurred in the press-fit group (115 stems). In the cemented group (177 stems), 2 shoulders (1.18%) were identified with radiographically loose stems. No loosening occurred in the press-fit group. No statistically significant difference was found in humeral stem loosening when the press-fit group and the cemented group were compared (P = .198). DISCUSSION: Our study indicates the cemented or press-fit RTSA system will result in a low incidence of radiolucent lines and radiographic loosening. Compared with historical survivorship of conventional anatomic total shoulder arthroplasty, RTSA shows a lower rate of radiographic stem loosening at a mean of 38.46 months. CONCLUSIONS: The RTSA has a low incidence of humeral stem loosening at midterm. These results underscore the importance of careful selection of patients to provide the benefits of this surgical technique. Press-fit fixation may provide a lower risk to stem loosening.
Authors: Derek D Berglund; Dragomir Mijic; Tsun Yee Law; Jennifer Kurowicki; Samuel Rosas; Jonathan C Levy Journal: J Shoulder Elbow Surg Date: 2018-11-02 Impact factor: 3.019
Authors: Chlodwig Kirchhoff; Marc Beirer; Ulrich Brunner; Arne Buchholz; Peter Biberthaler; Moritz Crönlein Journal: Int Orthop Date: 2018-01-20 Impact factor: 3.075
Authors: Yaiza Lopiz; Carlos García-Fernandez; María Vallejo-Carrasco; Daniel Garriguez-Pérez; Loreto Achaerandio; Carmen Tesoro-Gonzalo; Fernando Marco Journal: Int Orthop Date: 2022-01-16 Impact factor: 3.075
Authors: Sarav S Shah; Benjamin T Gaal; Alexander M Roche; Surena Namdari; Brian M Grawe; Macy Lawler; Stewart Dalton; Joseph J King; Joshua Helmkamp; Grant E Garrigues; Thomas W Wright; Bradley S Schoch; Kyle Flik; Randall J Otto; Richard Jones; Andrew Jawa; Peter McCann; Joseph Abboud; Gabe Horneff; Glen Ross; Richard Friedman; Eric T Ricchetti; Douglas Boardman; Robert Z Tashjian; Lawrence V Gulotta Journal: JSES Int Date: 2020-09-07
Authors: Tyler J Brolin; Ryan M Cox; John G Horneff Iii; Surena Namdari; Joseph A Abboud; Kristen Nicholson; Matthew L Ramsey Journal: Arch Bone Jt Surg Date: 2020-01