Barnett John S, Dopirak R Mychael, Brej Benjamin L, Katayama Erryk S, Patel Akshar V, Cvetanovich Gregory L, Bishop Julie Y, Rauck Ryan C
Department of Orthopaedics, The Ohio State University College of Medicine, Columbus, OH, USA.
J Orthop. 2024 Oct 29;63:58-63. doi: 10.1016/j.jor.2024.10.042. eCollection 2025 May.
Over time, the use of reverse total shoulder arthroplasty (RTSA) treating proximal humerus fractures (PHFs) and fracture sequelae has grown significantly due to its demonstrated effectiveness over open reduction internal fixation (ORIF) and hemiarthroplasty (HA). Cemented humeral stems have been widely utilized in RTSA for PHF, however cementless alternatives have become increasingly popular. This study seeks to analyze outcomes and complications in patients undergoing RTSA for fracture with uncemented and cemented stems at mid-term follow-up.
Patient records were queried for all patients who underwent reverse total shoulder arthroplasty for fracture with between January 7, 2009 and January 10, 2019 and completed a minimum follow-up of 2 years. Demographics characteristics, post-operative functional measurements, complications, and radiographs were assessed. A 5-year Kaplan-Meier survival analysis was performed.
A total of 23 patients encompassing 11 cemented and 12 uncemented stems met the inclusion criteria. The mean age of the uncemented cohort was 70.0 ± 9.8 years with a mean follow-up of 2.6 ± 1.3 years while the mean age of the cemented cohort was 68.9 ± 9.2 years with a mean follow-up of 2.9 ± 1.1 years. No differences in strength, range of motion, or survival between groups were observed. Two patients in the cemented cohort demonstrated humeral component loosening on follow-up radiographs.
Uncemented and cemented humeral fixation during RTSA for proximal humerus fracture leads to similar outcomes, and thus both are safe and effective methods of achieving humeral fixation in fracture patients.
随着时间的推移，由于反式全肩关节置换术（RTSA）在治疗肱骨近端骨折（PHF）及其骨折后遗症方面比切开复位内固定术（ORIF）和半关节置换术（HA）更具疗效，其应用显著增加。骨水泥型肱骨干假体已广泛应用于RTSA治疗PHF，然而非骨水泥型假体也越来越受欢迎。本研究旨在分析中期随访时接受RTSA治疗骨折的患者使用非骨水泥型和骨水泥型假体的疗效及并发症。
查询2009年1月7日至2019年1月10日期间接受反式全肩关节置换术治疗骨折且完成至少2年随访的所有患者的病历。评估人口统计学特征、术后功能测量、并发症及X线片情况。进行5年的Kaplan-Meier生存分析。
共有23例患者符合纳入标准，其中11例使用骨水泥型假体，12例使用非骨水泥型假体。非骨水泥型假体组患者的平均年龄为70.0±9.8岁，平均随访时间为2.6±1.3年；骨水泥型假体组患者的平均年龄为68.9±9.2岁，平均随访时间为2.9±1.1年。两组在力量、活动范围或生存率方面未观察到差异。骨水泥型假体组有2例患者在随访X线片上显示肱骨假体松动。
RTSA治疗肱骨近端骨折时，非骨水泥型和骨水泥型肱骨固定的疗效相似，因此两者都是骨折患者实现肱骨固定的安全有效方法。
