Humeral Stem Loosening Following Reverse Shoulder Arthroplasty A Systematic Review and Meta-Analysis
In a systematic review, these authors found that aseptic loosening of the reverse total shoulder humeral component increased with time after surgery and was more occurred more commonly found in patients with proximal bone loss: highest rate of aseptic stem loosening occurred in the tumor subgroup (10.8%), followed by RSA as a revision procedure after a failed arthroplasty (3.7%).
In a systematic review, these authors found that aseptic loosening of the reverse total shoulder humeral component increased with time after surgery and was more occurred more commonly found in patients with proximal bone loss: highest rate of aseptic stem loosening occurred in the tumor subgroup (10.8%), followed by RSA as a revision procedure after a failed arthroplasty (3.7%).
Comment: The humeral component of a reverse total shoulder requires secure fixation so that it can resist the torque applied to it. When the proximal humerus is intact, achieving secure fixation using impaction grafting is usually straightforward as shown below
However, when the bone of the proximal humerus is deficient, the cylindrical stem in a cylindrical canal has difficulty resisting applied torque.
As the reader quickly observes in the cases shown above, any loose humeral component carries a likelihood of being infected.
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