Uncemented versus cemented humeral stem fixation in reverse shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Musculoskeletal Research

Background:

• Reverse total shoulder arthroplasty (RTSA) is a common procedure for complex shoulder pathologies.
• Humeral fixation methods, cemented versus uncemented, are critical for long-term implant success.
• Understanding the comparative outcomes of these fixation techniques is essential for surgical decision-making.

Purpose of the Study:

• To compare radiographic and functional outcomes between uncemented and cemented humeral fixation in primary RTSA.
• To evaluate the efficacy and safety of press-fit humeral stems versus cemented stems.
• To identify any significant differences in complication rates and revision rates between the two fixation methods.

Main Methods:

• A prospective database review of primary RTSA patients (2007-2010) using a specific manufacturer's implant.
• Inclusion of patients with grit-blasted metaphyseal humeral stems and a minimum two-year follow-up.
• Exclusion of RTSA for fractures, fracture sequelae, or inflammatory arthropathy; comparison of radiographic and functional outcomes.

Main Results:

• No significant differences in functional improvement (SST-12, SF-12, SPADI-130, ASES, Constant scores) or range of motion between groups.
• Similar low rates of humeral loosening (2% uncemented, 3% cemented) and overall component revision (6% in both groups).
• Mean follow-up of 3.5 years for 80-89% of patients in each group.

Conclusions:

• Humeral component press-fitting in RTSA yields comparable radiographic and functional outcomes to cementation.
• Uncemented fixation is a viable alternative to cemented fixation in primary RTSA.
• Both methods demonstrate similar efficacy and safety profiles at a minimum two-year follow-up.