Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?
Clinics in Shoulder and Elbow
;
: 245-251, 2023.
Article
in English
| WPRIM
| ID: wpr-1000217
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.
Full text:
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Index:
WPRIM (Western Pacific)
Language:
English
Journal:
Clinics in Shoulder and Elbow
Year:
2023
Type:
Article
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