Greater Tuberosity Healing Rate and Clinical Results Following RSA Are Similar for Two Fracture-Specific Implant...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Geriatric Medicine

Background:

• Fracture-specific reverse shoulder arthroplasty (RSA) systems are available.
• The impact of prosthesis type and fixation method on tuberosity healing and functional outcomes in RSA for proximal humerus fractures is not fully understood.

Purpose of the Study:

• To compare the tuberosity healing rates and functional outcomes of two fracture-specific RSA systems.
• To evaluate the influence of cemented versus non-cemented fixation on RSA outcomes for proximal humerus fractures.

Main Methods:

• Retrospective cohort multicenter study of 146 patients undergoing RSA for acute three- or four-part proximal humerus fractures.
• Minimum follow-up of one year, with operations performed by six fellowship-trained surgeons.
• Comparison between Tornier Aequalis and Depuy Delta Xtend implants, with analysis of cemented and non-cemented fixation.

Main Results:

• Tuberosity healing rates were similar between the Aequalis (71%) and Delta Xtend (82%) systems (p=0.15).
• Cemented (73%) and non-cemented (83%) fixation also showed similar tuberosity healing rates (p=0.22).
• No significant differences in motion and functional outcomes were observed between implant types.

Conclusions:

• Reverse shoulder arthroplasty for complex proximal humerus fractures in the elderly yields comparable short-term results.
• The choice of fracture-specific implant and fixation technique (cemented vs. cementless) does not significantly affect early outcomes.