Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?
- Author:
Troy LI
1
;
Kenneth H. LEVY
;
Akiro H. DUEY
;
Akshar V. PATEL
;
Christopher A. WHITE
;
Carl M. CIRINO
;
Alexis WILLIAMS
;
Kathryn WHITELAW
;
Dave SHUKLA
;
Bradford O. PARSONS
;
Evan L. FLATOW
;
Paul J. CAGLE
Author Information
- Publication Type:Original Article
- From:Clinics in Shoulder and Elbow 2023;26(3):245-251
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair.
Methods:This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures.
Results:One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75).
Conclusions:In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores.Level of evidence: III.
