These authors present a radiographic review of 292 patients having primary reverse total shoulders for cuff tear arthropathy a mean of 38.5 months. The overall rate of loosening was 0.74%. No radiographic loosening occurred in the press-fit group (115 stems). In the cemented group (177 stems), 2 shoulders (1.18%) were identified with radiographically loose stems.
Comment: An important consideration in reading this paper is to note that that this series included only patients having primary reverse total shoulders for rotator cuff tear arthropathy. In these shoulders one would assume that the proximal humerus, including the tuberosities, were intact to control the height and version of the humeral component. Patients having reverse total shoulders for fractures or for failed prior arthroplasty - especially those with proximal humeral bone defects - may not fare as well.
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