Uncemented versus cemented humeral stem fixation in reverse shoulder arthroplasty.

Abstract

This study compares the radiographic and functional outcomes of uncemented and cemented humeral fixation in reverse total shoulder arthroplasty (RTSA). A prospective research database was reviewed for RTSA patients from 2007 to 2010. Inclusion criteria were primary RTSA from one manufacturer (Exactech Equinoxe®) with a grit-blasted metaphyseal humeral stem and two year minimum follow-up. Exclusion criteria included shoulder arthroplasty for fractures, fracture sequelae or inflammatory arthropathy. Radiographic and functional outcomes were compared between the uncemented and cemented groups. A total of 97 patients (58 women, 39 men) with 100 RTSAs met the inclusion criteria. Radiographic and clinical two year follow-up was available in 80% (51 RTSAs) of the uncemented group and 89% (32 RTSAs) of the cemented group (mean follow-up 3.5years). Average age at surgery was 72years. Both groups showed significant improvements in the 12-item Simple Shoulder Test (SST-12), 12-item Short Form (SF-12), Shoulder Pain and Disability Index 130 (SPADI-130), American Society of Shoulder and Elbow Surgeons (ASES) score and normalised Constant scores. One humeral loosening was seen in each group (2% uncemented, 3% cemented). Both groups' overall component revision rate was 6% (one in each group relating to humeral component failure). There were no significant differences in complication rates, change in functional scores and range of motion improvement. Humeral component press-fitting in RTSA provides similar outcomes as cementation at a minimum two year follow-up.