Abstract
Purpose:
While the use of press-fit humeral components has been accepted in total shoulder arthroplasty, few studies focus on the outcomes after uncemented reverse total shoulder arthroplasty. The purpose of this study is to compare the radiographic and functional results of uncemented and cemented humeral fixation in reverse total shoulder arthroplasty.
Materials/Methods:
A retrospective review was performed identifying all patients that underwent reverse total shoulder arthroplasty (RTSA) between May 2007 and December 2010. Medical records and a prospective research database were reviewed for demographic, operative, and clinical information. Inclusion criteria were a primary reverse total shoulder arthroplasty from one manufacturer with a grit-blasted humeral metaphyseal stem and minimum follow-up of 2 years. Exclusion criteria included shoulder arthroplasty for fractures, fracture sequelae, or inflammatory arthropathy. Antibiotics were not routinely added to the cement. The radiographic and functional outcomes were compared between the uncemented and cemented groups. Statistical analysis was performed using the Fisher Exact test to compare the dichotomous variables between the groups. The functional outcome data between the groups was calculated using the two-tailed Wilcoxon Rank Sum test.
Results:
Ninety-seven patients (58 females, 39 males) with 100 RTSA were identified and met the inclusion criteria from 214 arthroplasties performed in the study period. Radiographic and clinical 2-year follow-up was available in 80% (51 RTSAs) of the uncemented group (mean 2.7 years) and in 89% (32 RTSAs) of the cemented group (mean 3.5 years). Most common diagnosis was rotator cuff arthropathy (83%). Average age at surgery was 72 years (range 55–93 years). Humeral loosening was seen only in 1 patient (2%) in the uncemented group and in 1 patient (3.1%) in the uncemented group. Periprosthetic humerus fractures were seen in 5 patients (9.8%) in the uncemented group and in 1 patient (3.1%) in the cemented group with only the one in the cemented group requiring component revision. Infection was seen in 1 patient (2%) in the uncemented group and in none in the cemented group. Overall component revision rate was 5.9% in the uncemented group and 6.3% in the cemented group with one in each group relating to humeral component failure. Comparison of complication rates, change in functional outcome scores, and change in range of motion showed no significant differences between the uncemented and cemented components.
Conclusion:
Press-fitting of the humeral component in reverse shoulder arthroplasty provides similar radiographic and functional outcomes as cementation at 2 year follow-up with improvement in range of motion and functional outcome scores.
