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BMC Musculoskeletal Disorders

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Open Access 01-12-2022 | Research

Cemented vs. uncemented reverse total shoulder arthroplasty for the primary treatment of proximal humerus fractures in the elderly—a retrospective case–control study

Authors: Manuel Kramer, Martin Olach, Vilijam Zdravkovic, Melanie Manser, Bernhard Jost, Christian Spross

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

Uncemented reverse total shoulder arthroplasty (RTSA) for the primary treatment of proximal humerus fractures (PHF) in elderly patients was introduced at our institution in 2017. Recent reports have raised concerns about increased rates of early bone resorption at the proximal humerus with uncemented fracture stems. The aim of this study was to find out whether there was any difference in functional or radiographic outcomes between cemented and uncemented RTSA for PHF.

Methods

Seventeen consecutive patients who underwent uncemented RTSA (group nC) in 2017 and 2018 were age and sex matched (propensity score matching 1:2) to 34 patients with cemented RTSA implanted between 2011 and 2016 (group C) for the primary treatment of PHF. These two groups were compared in terms of clinical and radiographic outcomes at 2 years after the index surgery.

Results

The mean bone quality was low in both groups: in group nC the deltoid tuberosity index (DTI) was 1.43 (1.22–1.72) and in group C 1.42 (1.22–1.67). At the final 2 year follow-up, the relative CS was 98.3% (71–118) in group nC and 97.9% (36–125) in group C (p = 0.927); the absolute CS was 70.2 (49–89) in group nC and 68.0 (30–94) in group C (p = 0.509). Lucent lines at the humeral site were seen in 8 cases (47%) in group nC and in 13 cases (38%) in group C (p = 0.056). Compared to 3% in group C, all patients in group nC showed at least grade 1 and 65% showed grade 3 bone resorption at the proximal humerus (p < 0.001).

Conclusion

Compared to cemented RTSA bone resorption at the proximal humerus was significantly more frequent in patients with uncemented RTSA for PHF. So far, this is rather a radiographic than a clinical finding, because both groups showed very satisfying functional outcomes and low revision rates at the 2 year follow-up.

Level of Evidence III.

A retrospective case–control study.

Available only for authorised users

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Title: Cemented vs. uncemented reverse total shoulder arthroplasty for the primary treatment of proximal humerus fractures in the elderly—a retrospective case–control study
Authors: Manuel Kramer
Martin Olach
Vilijam Zdravkovic
Melanie Manser
Bernhard Jost
Christian Spross
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05994-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cemented vs. uncemented reverse total shoulder arthroplasty for the primary treatment of proximal humerus fractures in the elderly—a retrospective case–control study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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