Radiographic Stability of Ingrowth Humeral Stems in Total Shoulder Arthroplasty

Abstract

Background Cemented and uncemented stem types are available for TSA. An early uncemented stem designed for bone ingrowth had radiographic loosening of approximately 10% at intermediate followup (mean 4.6 years). Subsequent stem modifications included circumferential metaphyseal porous coating to enhance ingrowth and reduce loosening rates. Questions/purposes We asked whether the radiographic loosening rates would be lower after this design modification and whether the pain score and ROM would be improved. Patients and MethodsWe reviewed the medical records and radiographs of 76 patients undergoing primary TSA with circumferential metaphyseal porous-coated stems for osteoarthritis between 1995 and 2005. All patients had a complete standardized series of radiographs preoperatively, postoperatively, and at final followup. Humeral stems were evaluated for any radiolucent lines by zone, progression of lucencies, and shift in component position.The minimum radiographic followup was 25 months (average, 52 months; range, 25-90 months).

Radiographic Changes Around Humeral Components in Shoulder Arthroplasty

“…Compared with earlier series, the implant survival rate in the present study is encouraging 9,[11][12][13]32 . Very good results have been reported for cemented stems in the past, and it seems that loosening of a cemented stem is exceptionally rare 11,15,[33][34][35] .…”

Porous metals and alternate bearing surfaces in shoulder arthroplasty

“…The next-generation prosthesis contained a circumferential porous coating around the proximal one fourth of the stem in an effort to improve humeral fixation. Retrospective analysis of two surgeons' experience with 76 patients using these stems revealed few radiolucencies and no loosening at an average of 52 months follow-up [52]. This study changed the surgeons' practice, and now, humeral stems are cemented only when a bony deficit is present.…”

Integrating Rehabilitation Engineering Technology With Biologics

“…The natural process of OI was discovered by Swedish professor Per‐Ingvar Brånemark in 1952 while he was performing experiments aimed at studying wound healing and blood flow in bone [90]. Since the 1980s, OI has been used widely in the clinic for dental implants [91] and more recently in bone‐anchored hearing aids [92] and total joint arthroplasty [93,94]. The first clinical testing of OI for prosthetic limbs began in Sweden in 1990 [95].…”