Fractures adjacent to humeral prostheses.

Cementless surface replacement arthroplasty of the shoulder

“…The incidence of periprosthetic fractures has been quoted as 3% and accounts for approximately 20% of all complications associated with total shoulder arthroplasty both during surgery and later. [18][19][20][21][22][23] At the time of operation no major complications were encountered; in particular there was no fracture or perforation of the shaft of the humerus since no preparation of it had been required. Stemmed prostheses create a stress riser effect at the tip of the stem in the midshaft of the humerus.…”

“…Stemmed prostheses create a stress riser effect at the tip of the stem in the midshaft of the humerus. 19,20,[22][23][24] The key to correct anatomical alignment of the humeral component is the identification of the anatomical neck. Previous reports of cemented prostheses have also noted a high incidence of lucency around the components.…”

Periprosthetic Fractures Associated with Primary Total Shoulder Arthroplasty and Primary Humeral Head Replacement

“…This finding is consistent with our previous study's finding of a significantly increased risk of intraoperative humeral fractures in women treated from 1980 to 2002 with total shoulder arthroplasty, humeral head replacement, or revision shoulder arthroplasty 7 . There are several potential explanations for this increased risk in women, including the fact that they have a higher prevalence of osteoporosis and rheumatoid arthritis, both of which are risk factors for periprosthetic fractures 18,19 . Similarly, we also found that female sex was associated with a higher risk of intraoperative humeral shaft fractures, a subset of all humeral fractures.…”

Stemless shoulder arthroplasty—current results and designs

“…These implants both have a porous plasma spray coating allowing for cementless implantation. Shortening of the stem as well as cementless application techniques have been incorporated to try and reduce humeral stem complications [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The incidence of intraoperative humeral fractures in total shoulder arthroplasty is 1.5 %, and the incidence of postoperative periprosthetic humeral fracture is between 1.6 and 2.3 % [2,11].…”