Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?
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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Shoulder and Elbow Society
2023-09-01
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| Series: | Clinics in Shoulder and Elbow |
| Subjects: | |
| Online Access: | http://www.cisejournal.org/upload/pdf/cise-2023-00199.pdf |
| _version_ | 1797326923586600960 |
|---|---|
| author | Troy Li 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_facet | Troy Li 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_sort | Troy Li |
| collection | DOAJ |
| description | 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 evidenceIII. |
| first_indexed | 2024-03-08T06:32:11Z |
| format | Article |
| id | doaj.art-4d6e9dc3bda14312b765c705c1232f85 |
| institution | Directory Open Access Journal |
| issn | 2288-8721 |
| language | English |
| last_indexed | 2024-03-08T06:32:11Z |
| publishDate | 2023-09-01 |
| publisher | Korean Shoulder and Elbow Society |
| record_format | Article |
| series | Clinics in Shoulder and Elbow |
| spelling | doaj.art-4d6e9dc3bda14312b765c705c1232f852024-02-03T11:18:59ZengKorean Shoulder and Elbow SocietyClinics in Shoulder and Elbow2288-87212023-09-0126324525110.5397/cise.2023.00199927Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?Troy Li0Kenneth H. Levy1Akiro H. Duey2Akshar V. Patel3Christopher A. White4Carl M. Cirino5Alexis Williams6Kathryn Whitelaw7Dave Shukla8Bradford O. Parsons9Evan L. Flatow10Paul J. Cagle11 Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USABackground 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 evidenceIII.http://www.cisejournal.org/upload/pdf/cise-2023-00199.pdfreplacement arthroplastyshoulderpress-fitcementedlong-term outcomes |
| spellingShingle | Troy Li 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 Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty? Clinics in Shoulder and Elbow replacement arthroplasty shoulder press-fit cemented long-term outcomes |
| title | Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty? |
| title_full | Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty? |
| title_fullStr | Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty? |
| title_full_unstemmed | Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty? |
| title_short | Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty? |
| title_sort | does humeral fixation technique affect long term outcomes of total shoulder arthroplasty |
| topic | replacement arthroplasty shoulder press-fit cemented long-term outcomes |
| url | http://www.cisejournal.org/upload/pdf/cise-2023-00199.pdf |
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