Clinical results and radiological bony adaptations on a cementless short-stem prosthesis – A comparative study between anatomical and reverse total shoulder arthroplasty - 15/05/22
, Ramy Samargandi b, Luc Favard b
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Abstract |
Introduction |
Although the use of short stem and stemless shoulder prosthesis is trending, the surgical outcome may vary due to varying biomechanics. Objectives were to evaluate and compare the short-term clinical results and radiological changes between anatomical total shoulder arthroplasty (TSA) and reverse TSA (rTSA) with a short-stem humeral design.
Hypothesis |
There is no clinical and radiological difference between TSA and rTSA using a short-stem humeral design.
Methods |
This retrospective study included 66 patients who underwent TSA and rTSA (33 patients each) with a minimum 2-year follow-up. Radiographic findings, including preoperative Tingart cortical index (TCI), postoperative filling ratios of metaphysis (FRmet) and diaphysis (FRdia), bone adaptations, and osteolysis around the humeral stem at the immediate postoperative period, and the most recent follow-up were measured. Pre and postoperative Constant-Murley score, subjective shoulder value (SSV), and complications were noted.
Results |
At a mean follow-up of 27 (range 24–50) months, FRmet was significantly higher in rTSA group than the TSA group (0.65 vs. 0.60, p=0.009). Bone resorption was similar in both groups (p=0.76) and was correlated to a lower TCI value of<2.9mm (p=0.02). Despite significant clinical improvement in individual groups, the comparison between groups was non-significant (p>0.05). Negative correlation was observed between TCI and total clinical score (p=0.045) in TSA group, active external rotation (p=0.019), activity (p=0.005), SSV (p=0.008) and total score (p=0.025) in rTSA group. Radiographic changes were not influenced by patient characteristics and clinical results (p>0.05).
Conclusion |
Although no radiographic difference was observed between TSA and rTSA, better short-term clinical results observed with the usage of the short-stem humeral design prosthesis are encouraging.
Level of evidence |
III; Retrospective cohort study.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Short stem prosthesis, Cementless fixation, Shoulder prosthesis, Humeral filling ratio, Humeral platform system
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Vol 108 - N° 3
Articolo 103262- maggio 2022 Ritorno al numero
Articolo precedente
- Arthroplasty for weight-bearing shoulders
- Léo Chiche, Jacques Teissier, Anthony Gelis, Michel Chammas, Isabelle Laffont, Bertrand Coulet
- Assessment of intraoperative bleeding in reverse shoulder arthroplasty – with or without a stem
- Fiona Sakek, Harrison Haight, Pierre Tuphé, Inès Regas, Antoine Adam, Séverin Rochet, Tristan Lascar, Laurent Obert, François Loisel
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.