Patrick J Denard1, Matthew P Noyes2, J Brock Walker3, Yousef Shishani4, Reuben Gobezie4, Anthony A Romeo5, Evan Lederman6. 1. Southern Oregon Orthopedics, Medford, OR, USA; Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, OR, USA. Electronic address: pjdenard@gmail.com. 2. Southern Oregon Orthopedics, Medford, OR, USA. 3. Department of Orthopaedic Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA. 4. The Cleveland Shoulder Institute, Beachwood, OH, USA. 5. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA. 6. Department of Orthopaedic Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA; The Orthopedic Clinic Association, Phoenix, AZ, USA.
Abstract
BACKGROUND: This study compared the outcome and radiographic humeral adaptations after placement of a traditional-length (TL) or short-stem (SS) humeral component during total shoulder arthroplasty (TSA). The hypothesis was there would be no difference in outcome or radiographic adaptations. METHODS: A multicenter retrospective review was performed of primary TSAs performed with a TL or SS press-fit humeral component. The stems were identical in geometry and coating, with the only variable being stem length. Functional outcome and radiographs were reviewed at a minimum of 2 years postoperatively in 58 TL stems and 56 SSs. RESULTS: There were significant improvements in all range of motion and functional outcome from baseline (P < .001) but no difference between the groups (P > .05). TL stems were placed in anatomic alignment 98% of the time compared with 86% of the SS cases (P = .015), but alignment did not influence outcome. Cortical thinning was more common in the medial metaphysis with the TL stem (74%) than with the SS (50%; P = .008). Partial calcar osteolysis was seen in 31% of TL stems and in 23% of SSs (P = .348). There was no difference in loosening or shift between the 2 groups. CONCLUSION: There is no difference in functional outcome at short-term follow-up between a TL stem and a SS in TSA. The pattern of radiographic adaptations may differ based on stem length. Further study is needed to evaluate the mid- to long-term differences, particularly with regard to calcar osteolysis.
BACKGROUND: This study compared the outcome and radiographic humeral adaptations after placement of a traditional-length (TL) or short-stem (SS) humeral component during total shoulder arthroplasty (TSA). The hypothesis was there would be no difference in outcome or radiographic adaptations. METHODS: A multicenter retrospective review was performed of primary TSAs performed with a TL or SS press-fit humeral component. The stems were identical in geometry and coating, with the only variable being stem length. Functional outcome and radiographs were reviewed at a minimum of 2 years postoperatively in 58 TL stems and 56 SSs. RESULTS: There were significant improvements in all range of motion and functional outcome from baseline (P < .001) but no difference between the groups (P > .05). TL stems were placed in anatomic alignment 98% of the time compared with 86% of the SS cases (P = .015), but alignment did not influence outcome. Cortical thinning was more common in the medial metaphysis with the TL stem (74%) than with the SS (50%; P = .008). Partial calcar osteolysis was seen in 31% of TL stems and in 23% of SSs (P = .348). There was no difference in loosening or shift between the 2 groups. CONCLUSION: There is no difference in functional outcome at short-term follow-up between a TL stem and a SS in TSA. The pattern of radiographic adaptations may differ based on stem length. Further study is needed to evaluate the mid- to long-term differences, particularly with regard to calcar osteolysis.
Authors: Elliott W Cole; Samuel G Moulton; Reuben Gobezie; Anthony A Romeo; J Brock Walker; Evan Lederman; Patrick J Denard Journal: JSES Int Date: 2020-01-02
Authors: Lisa Peduzzi; Thomas Goetzmann; Frank Wein; Olivier Roche; François Sirveaux; Daniel Mole; Adrien Jacquot Journal: JSES Open Access Date: 2019-11-29