Cemented Versus Uncemented Reverse Shoulder Arthroplasty Treatment of Proximal Humerus Fractures: National Shoulder Arthroplasty Data from Türkiye

Background@#This study evaluated national trends in cemented and uncemented reverse shoulder arthroplasty (RSA) for proximal humerus fractures using a comprehensive national surgical database. This study aimed to compare RSA used in the treatment of proximal humerus fractures with the literature and to determine the country's trend. @*Methods@#A cross-sectional study was conducted using the health records of individuals aged ≥ 18 years who underwent RSA for proximal humerus fractures between 2016 and 2022. Patients were divided into cemented and uncemented groups, and demographic data (age, sex), duration of hospital stay, transfusions, revisions, mortality, and Charlson Comorbidity Index (CCI) scores were analyzed. @*Results@#A total of 618 cemented RSA and 1,364 uncemented RSA procedures were reviewed. Patients who underwent cemented RSA were significantly older than those who had uncemented RSA (p = 0.002). Transfusion rates were higher in the cemented RSA group (p = 0.006). The frequency of revision surgery was 6.1%. Younger age and male sex were associated with revision (p < 0.001). CCI scores were higher among transfused patients than non-transfused patients (p < 0.001). The incidence of cemented RSA was 11.7% and 49% in 2016 and 2022, respectively. Differences were found among hospital types and geographical regions. @*Conclusions@#While cemented RSA has been gaining attention and increased application in recent years for proximal humerus fractures, uncemented RSA still predominates. The choice between these 2 methods is largely influenced by regional and hospitallevel factors. The type of RSA and high CCI scores were found to have no significant impact on the risk of surgical revision.

Elevation of B-type natriuretic peptide level in asymptomatic Hepatitis B virus-positive patients is not associated with abnormalities of cardiac function

To compare B-type natriuretic peptide [BNP] and echocardiographic parameters in patients with hepatitis B virus [HBV] and healthy control subjects. 52 consecutive patients with HBV and 47 healthy controls were examined. All subjects underwent transthoracic echocardiography after a complete medical history and laboratory examination including BNP, C-reactive protein [CRP] and high-sensitivity CRP [hsCRP]. Demographic characteristics were similar in patients with HBV and the control group. No significant difference was found in conventional Doppler and tissue Doppler parameters between the two groups. BNP levels were significantly higher in patients with HBV [6.5 ng/l [range 0.5-85.2]] than controls [4.3 ng/l [range 0.5-18.3]], p = 0.039. hsCRP [3.25 mg/l [0.02-40.2] vs. 0.5 mg/l [0.02-8.0]] levels were significantly higher in patients with HBV than control subjects [p < 0.001]. Patients with HBV had higher BNP, CRP, and hsCRP levels than controls. Echocardiographic findings were similar in both groups. This slight BNP elevation in HBV patients may be related to chronic inflammation due to HBV