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Orthopedics, 2019;42(2):e236–e241
Cite this articlePublished Online:https://doi.org/10.3928/01477447-20190125-03Cited by:20

Abstract

Reverse shoulder arthroplasty (RSA) for proximal humerus fractures (PHFs) is traditionally performed with cemented humeral fixation. The purpose of this study was to compare the clinical and radiographic outcomes of cemented and cementless RSA for PHF. Between 2010 and 2014, 38 acute PHFs were treated with RSA and followed for a minimum of 2 years (mean, 37 months; range, 24–66 months). The mean time from fracture to RSA was 7 days (range, 1–30 days). Humeral stems were cemented in 19 shoulders and uncemented in 19 shoulders. Outcome measures included visual analog scale pain scores, range of motion, postoperative Quick Disabilities of the Arm, Shoulder and Hand scores, American Shoulder and Elbow Surgeons scores, and radiographic parameters. The 2 groups had similar visual analog scale pain scores, postoperative range of motion, and Quick Disabilities of the Arm, Shoulder and Hand scores (P>.05). American Shoulder and Elbow Surgeons scores and satisfaction scores were significantly higher with cemented humeral fixation (76.3 vs 48.0, P=.005; 1.2 vs 1.8, P=.04). Radiographically, there was no difference in terms of tuberosity healing, component loosening, or notching (P>.05). Reverse shoulder arthroplasty provides pain relief for PHF, regardless of humeral fixation. In this cohort, cementless fixation was associated with worse patient-reported outcomes, although no correlation could be established with pain, motion, or tuberosity healing. Further studies are required before cementless fixation can be recommended for RSA for fracture. [Orthopedics. 2019; 42(2):e236–e241.]

  • 1.Aaron D, Shatsky J, Paredes JC, Jiang C, Parsons BO, Flatow EL. Proximal humeral fractures: internal fixation. Instr Course Lect. 2013; 62:143–154.

    > MedlineGoogle Scholar
  • 2.Südkamp N, Bayer J, Hepp P, et al.Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate: results of a prospective, multicenter, observational study. J Bone Joint Surg Am. 2009; 91(6):1320–1328.10.2106/JBJS.H.00006

    > Crossref MedlineGoogle Scholar
  • 3.Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Molé D. Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elbow Surg. 2002; 11(5):401–412.10.1067/mse.2002.124527

    > Crossref MedlineGoogle Scholar
  • 4.Khatib O, Onyekwelu I, Yu S, Zuckerman JD. Shoulder arthroplasty in New York State, 1991 to 2010: changing patterns of utilization. J Shoulder Elbow Surg. 2015; 24(10):E286–E291.10.1016/j.jse.2015.05.038

    > Crossref MedlineGoogle Scholar
  • 5.Han RJ, Sing DC, Feeley BT, Ma CB, Zhang AL. Proximal humerus fragility fractures: recent trends in nonoperative and operative treatment in the Medicare population. J Shoulder Elbow Surg. 2016; 25(2):256–261.10.1016/j.jse.2015.07.015

    > Crossref MedlineGoogle Scholar
  • 6.Schairer WW, Nwachukwu BU, Lyman S, Craig EV, Gulotta LV. National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elbow Surg. 2015; 24(1):91–97.10.1016/j.jse.2014.08.026

    > Crossref MedlineGoogle Scholar
  • 7.Bufquin T, Hersan A, Hubert L, Massin P. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly: a prospective review of 43 cases with a short-term follow-up. J Bone Joint Surg Br. 2007; 89(4):516–520.10.1302/0301-620X.89B4.18435

    > Crossref MedlineGoogle Scholar
  • 8.Phadnis J, Huang T, Watts A, Krishnan J, Bain GI. Cemented or cementless humeral fixation in reverse total shoulder arthroplasty? A systematic review. Bone Joint J. 2016; 98-B(1):65–74.10.1302/0301-620X.98B1.36336

    > Crossref MedlineGoogle Scholar
  • 9.Ross M, Hope B, Stokes A, Peters SE, McLeod I, Duke PF. Reverse shoulder arthroplasty for the treatment of three-part and four-part proximal humeral fractures in the elderly. J Shoulder Elbow Surg. 2015; 24(2):215–222.10.1016/j.jse.2014.05.022

    > Crossref MedlineGoogle Scholar
  • 10.Youn SM, Deo S, Poon PC. Functional and radiologic outcomes of uncemented reverse shoulder arthroplasty in proximal humeral fractures: cementing the humeral component is not necessary. J Shoulder Elbow Surg. 2016; 25(4):E83–E89.10.1016/j.jse.2015.09.007

    > Crossref MedlineGoogle Scholar
  • 11.Smith AM, Barnes SA, Sperling JW, Farrell CM, Cummings JD, Cofield RH. Patient and physician-assessed shoulder function after arthroplasty. J Bone Joint Surg Am. 2006; 88(3):508–513.

    > MedlineGoogle Scholar
  • 12.Neer CS. Displaced proximal humeral fractures: Part I. Classification and evaluation. Clin Orthop Relat Res. 2006; 442:77–82.10.1097/01.blo.0000198718.91223.ca

    > Crossref MedlineGoogle Scholar
  • 13.Sanchez-Sotelo J, Wright TW, O'Driscoll SW, Cofield RH, Rowland CM. Radiographic assessment of uncemented humeral components in total shoulder arthroplasty. J Arthroplasty. 2001; 16(2):180–187.10.1054/arth.2001.20905

    > Crossref MedlineGoogle Scholar
  • 14.Sanchez-Sotelo J, O'Driscoll SW, Torchia ME, Cofield RH, Rowland CM. Radiographic assessment of cemented humeral components in total shoulder arthroplasty. J Shoulder Elbow Surg. 2001; 10(6):526–531.10.1067/mse.2001.118482

    > Crossref MedlineGoogle Scholar
  • 15.Lazarus MD, Jensen KL, Southworth C, Matsen FA. The radiographic evaluation of keeled and pegged glenoid component insertion. J Bone Joint Surg Am. 2002; 84(7):1174–1182.10.2106/00004623-200207000-00013

    > Crossref MedlineGoogle Scholar
  • 16.Sirveaux F, Favard L, Oudet D, Huquet D, Walch G, Molé D. Grammont inverted total shoulder arthroplasty in the treatment of glenohumeral osteoarthritis with massive rupture of the cuff: results of a multicentre study of 80 shoulders. J Bone Joint Surg Br. 2004; 86(3):388–395.10.1302/0301-620X.86B3.14024

    > Crossref MedlineGoogle Scholar
  • 17.Gallinet D, Clappaz P, Garbuio P, Tropet Y, Obert L. Three or four parts complex proximal humerus fractures: hemiarthroplasty versus reverse prosthesis. A comparative study of 40 cases. Orthop Traumatol Surg Res. 2009; 95(1):48–55.10.1016/j.otsr.2008.09.002

    > Crossref MedlineGoogle Scholar
  • 18.Klein M, Juschka M, Hinkenjann B, Scherger B, Ostermann PAW. Treatment of comminuted fractures of the proximal humerus in elderly patients with the Delta III reverse shoulder prosthesis. J Orthop Trauma. 2008; 22(10):698–704.10.1097/BOT.0b013e31818afe40

    > Crossref MedlineGoogle Scholar
  • 19.Gallinet D, Adam A, Gasse N, Rochet S, Obert L. Improvement in shoulder rotation in complex shoulder fractures treated by reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2013; 22(1):38–44.10.1016/j.jse.2012.03.011

    > Crossref MedlineGoogle Scholar
  • 20.Spormann C, Durchholz H, Audigé L, et al.Patterns of proximal humeral bone resorption after total shoulder arthroplasty with an uncemented rectangular stem. J Shoulder Elbow Surg. 2014; 23(7):1028–1035.10.1016/j.jse.2014.02.024

    > Crossref MedlineGoogle Scholar
  • 21.Raiss P, Edwards TB, Deutsch A, et al.Radiographic changes around humeral components in shoulder arthroplasty. J Bone Joint Surg Am. 2014; 96(7):E54.10.2106/JBJS.M.00378

    > Crossref MedlineGoogle Scholar
  • 22.Melis B, DeFranco M, Lädermann A, et al.An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years. J Bone Joint Surg Br. 2011; 93(9):1240–1246.10.1302/0301-620X.93B9.25926

    > Crossref MedlineGoogle Scholar
  • 23.Somersalo A, Paloneva J, Kautiainen H, Lönnroos E, Heinänen M, Kiviranta I. Increased mortality after upper extremity fracture requiring inpatient care. Acta Orthop. 2015; 86(5):533–557.10.3109/17453674.2015.1043833

    > Crossref MedlineGoogle Scholar

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