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Complications and revision rates linked with humeral implant designs in reverse shoulder arthroplasty elucidated

Complications and revision rates linked with humeral implant designs in reverse shoulder arthroplasty elucidated Complications and revision rates linked with humeral implant designs in reverse shoulder arthroplasty elucidated
Complications and revision rates linked with humeral implant designs in reverse shoulder arthroplasty elucidated Complications and revision rates linked with humeral implant designs in reverse shoulder arthroplasty elucidated

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Improvement in component design allowing for press-fit fixation can help reduce humeral-sided failure and radiographic slackening in reverse shoulder arthroplasty.

As per a study published in ‘Journal of Shoulder and Elbow Surgery’, the first-generation cemented modular and the second-generation monolithic humeral stem implant were found to have comparable clinical outcomes in reverse total shoulder arthroplasty (RSA). Also, there was a noteworthy decrease in the occurrence of radiographic loosening and requirement for revision with monolithic stem primarily utilizing press fit fixation than cemented stem.


The outcomes, revisions, and complications between a first-generation cemented and a second-generation monolithic, chiefly uncemented humeral implant in RSA with 135-degree neck-shaft angle and changing degrees of metallic glenosphere offsets were examined in this study by R. Allen Gorman et al.


The patients undergoing RSA from 2004-2014 were retrospectively evaluated with a first-generation cemented modular humeral implant (comprising of 400 patients, Group 1) or second-generation monolithic humeral stem (comprising of 231 patients, Group 2), with minimum 2-year clinical and radiographic follow-up.


As found (Table 1 A and B), both groups had similar improvement of clinical outcomes (ASES +30 points versus +34 points) with improvements in all planes of motion.



Table 1 A and B: Pre- and postoperative patient-reported outcome measures and range of motion measurements at 2+ years in Group 1 and Group 2; p value <0.0001

The occurrence of humeral loosening for the cemented group was 3.6%, then 0.4% in the uncemented group. All in all, the revision was observed in 28 shoulders treated with cementing method (4.0%) and 6 patients treated by press-fit method (1.5%). Rate of postoperative acromial fractures within the first year was 3.4% in the cemented group and 1.8% in the uncemented group.

Source:

Journal of Shoulder and Elbow Surgery

Article:

A cohort comparison of humeral implant designs in reverse shoulder arthroplasty: does implant design lead to lower rates of complications and revision?

Authors:

R. AllenGormanII et al.

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