Friday, April 11, 2014

Short-stem uncemented reverse shoulder arthroplasty - does it offer any advantage

Short-stem uncemented primary reverse shoulder arthroplasty: clinical and radiological outcomes.

The authors conducted a retrospective review of 44 of their patients with a mean age of 76 years who underwent primary (no revisions) reverse TSR with a short uncemented humeral stem.

The stems were well-positioned, without evidence of significant valgus or varus malalignment in 42 (95.5%). There was no radiological evidence of loosening of the humeral stem in any patient; 13 (29.5%) had evidence of proximal humeral stress shielding and scapular notching was noted in three (6.8%).

Comment: While it is stated that 'short uncemented humeral stems can preserve humeral bone stock" it is unclear that there is more bone preservation with a short stemmed prosthesis:

Tight press fit of a short stubby stem without impaction grafting may also carry increased risk of stress shielding proximally and periprosthetic fracture at the distal tip of the stem. Thus at this point, we've not found an application for this type of prosthesis in our practice.

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