Long-term outcomes of cemented <i>versus</i> cementless humeral components in arthroplasty of the shoulder

Werthel, Jean David; Lonjon, Guillaume; Jo, Suenghwan; Cofield, Robert H.; Sperling, John W.; Elhassan, Bassem T.

doi:10.1302/0301-620x.99b5.bjj-2016-0910.r1

Cited by 45 publications

(15 citation statements)

References 36 publications

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“…Total shoulder arthroplasty (TSA) has been shown to be a reliable procedure for a variety of shoulder pathologies with good long-term results. 21,25 The goal of TSA is to relieve patients' pain and restore range of motion, in part by using a prosthesis that closely resembles the native glenohumeral joint anatomy. In theory, better restoration of the native glenohumeral joint anatomy should result in better postoperative function.…”

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confidence: 99%

Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

Cox

Sholder

Stoll

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Humeral stem designs for total shoulder arthroplasty have varied over the years, with a recent trend toward shorter stems. The purpose of this study was to examine the impact of humeral component stem length on the ability to restore the native humeral head anatomy. Methods: We performed a retrospective review including patients who underwent total shoulder arthroplasty for primary osteoarthritis between 2007 and 2017 with complete operative reports and adequate radiographs. Surgical data including stem design were collected. Preoperative and postoperative radiographic measurements of the center of rotation (COR), humeral head height (HH), and neck-shaft angle were performed. Restoration of the native humeral anatomy was deemed ''acceptable'' based on postoperative differences in the COR 3 mm, HH 5 mm, and neck-shaft angle > 130. Deviations between preoperative and postoperative measurements were compared across stem types. All available 2-year stemless implant radiographs were also analyzed. Results: In total, 261 patients were included, with 31 stemless, 43 short-stem, and 187 standard-stem implants. There was no significant difference in COR restoration in the x-axis direction (P ¼ .060) or y-axis direction (P ¼ .579). There was no significant difference in restoration of acceptable HH by stem type (P ¼ .339). Stemless arthroplasty implants were more likely to be placed in varus (22.6%) compared with short-stem (7.0%) and standard-stem (3.7%) designs (P < .001). Conclusion: Restoration of humeral anatomic parameters occurred significantly less with stemless implants than with short-and standard-stem implants. The stem of a shoulder arthroplasty implant aids surgeons in accurately restoring patient-specific anatomy.

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mentioning

confidence: 99%

Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

Cox

Sholder

Stoll

et al. 2021

Journal of Shoulder and Elbow Surgery

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“…The New Zealand registry showed a 2-year survival of 96.6% [21]. Five-year survival percentages vary between 94.4-98.9% [21][22][23]. In our study, the convertible group consisted of 37.6% hemiarthroplasties vs 39.4% in the non-convertible group.…”

Section: Discussionmentioning

confidence: 62%

Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study

Theelen

Mory

Venkatesan

et al. 2021

BMC Musculoskelet Disord

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Background Convertible stem designs allow for stem retention during revision from anatomical to reverse shoulder arthroplasty. In some cases conversion is not possible for example due to excessive soft tissue tensioning. In these cases a total revision is necessary. The primary aim of this Dutch registry study was to evaluate the unforeseen stem reversion percentages in revision of convertible anatomical shoulder arthroplasty to reverse shoulder arthroplasty. Methods Shoulder arthroplasties (n = 2834) performed between 2014 and 2016 registered in the Dutch Arthroplasty Registry were selected. In 2016 94% of primary arthroplasties and 92% of revision arthroplasties were registered in the database. Arthroplasties were selected on convertibility. Mean follow-up was 2.4 years. We analysed the number of revisions for convertible and non-convertible designs. Cases with obligatory revisions as periprosthetic joint infections, stem loosening and periprosthetic fractures were excluded. Kaplan-Meier analysis was used to calculate humeral stem survival. Multivariate cox-regression analysis was used to determine risk factors for stem revision. Results The majority of procedures (respectively 90.9 and 72.1% for the convertible and non-convertible group) concerned a conversion to reverse shoulder arthroplasty (p = .02). In the convertible group, the stem was retained in 29 out of 40 patients (72.5%). Overall implant survival was 94.5% after a mean follow-up of 2.4 years. Hemiartroplasty, fracture as primary indication, previous shoulder surgery and lower age were risk factors for revision. Conclusions Although convertible designs are gaining popularity due to their expected advantage in revision arthroplasty, surgeons should be aware that during a revision procedure in 27.5% of the patients an unforeseen stem revision is necessary.

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“…Aseptic loosening of the humeral implant is less commonly described, although it is a potential long-term problem, 5 with a reported rate of 9% of humeral loosening at 20 years. 6…”

Section: Introductionmentioning

confidence: 99%

Comparison of revision rates and radiographic observations of long and short, uncoated and coated humeral stem designs in total shoulder arthroplasty

Godenèche

Garret²,

Barth

et al. 2019

EFORT Open Reviews

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There is no consensus on outcomes of long versus short and uncoated versus coated uncemented stems in total shoulder arthroplasty (TSA). We reviewed the literature to compare revision rates and adverse radiographic observations at ⩾ 2 years of various uncemented humeral stem designs. We performed an electronic PubMed search for studies on uncemented primary TSA that reported one or more of the following observations at ⩾ 2 years for distinct stem designs: stem revision; subsidence; stress shielding; radiolucent lines; and humeral loosening. The search returned 258 records, from which 20 articles (22 cohorts) met the inclusion criteria. The most frequently reported designs were short uncoated stems (7/13 cohorts) at < 3 years and long uncoated stems (8/9 cohorts) at > 3 years. The incidences of revisions and adverse radiographic observations were lower for short coated designs, compared with short and long uncoated designs, but these findings should be confirmed by prospective studies with a longer follow-up. Cite this article: EFORT Open Rev 2019;4:70-76. DOI: 10.1302/2058-5241.4.180046.

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Long-term outcomes of cemented versus cementless humeral components in arthroplasty of the shoulder

Cited by 45 publications

References 36 publications

Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

Stem retention and survival in revision of anatomical convertible shoulder arthroplasty to reverse arthroplasty: a Dutch registry study

Comparison of revision rates and radiographic observations of long and short, uncoated and coated humeral stem designs in total shoulder arthroplasty

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