scholarly journals Value comparison of humeral component press-fit and cemented techniques in reverse shoulder arthroplasty

2019 ◽  
Vol 28 (3) ◽  
pp. 496-502 ◽  
Author(s):  
Derek D. Berglund ◽  
Dragomir Mijic ◽  
Tsun yee Law ◽  
Jennifer Kurowicki ◽  
Samuel Rosas ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Press Fit ◽  
Humeral Component

scholarly journals Short Humeral Stems in Shoulder Arthroplasty

2018 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Hwang Kyun Oh ◽  
Tae Kang Lim
Keyword(s):  
Shoulder Arthroplasty ◽  
Stress Shielding ◽  
Revision Arthroplasty ◽  
Porous Coating ◽  
Glenoid Component ◽  
Cylindrical Shape ◽  
Press Fit ◽  
Surface Finishes ◽  
Humeral Component ◽  
Metaphyseal Bone

Since the introduction of shoulder arthroplasty by Neer in 1974, the design of not only the glenoid component but also the humeral component used in shoulder arthroplasty has continually evolved. Changes to the design of the humeral component include a gradually disappearing proximal fin; diversified surface finishes (such as smooth, grit-blasted, and porous coating); a more contoured stem from the originally straight and cylindrical shape; and the use of press-fit uncemented fixation as opposed to cemented fixation. Despite the evolution of the humeral component for shoulder arthroplasty, however, stem-related complications are not uncommon. Examples of stem-related complications include intraoperative humeral fractures, stem loosening, periprosthetic fractures, and stress shielding. These become much more common in revision arthroplasty, where patients are associated with further complications such as surgical difficulty in extracting the humeral component, proximal metaphyseal bone loss due to stress shielding, intraoperative humeral shaft fractures, and incomplete cement removal. Physicians have made many attempts to reduce these complications by shortening the stem of the humeral component. In this review, we will discuss some of the limitations of long-stem humeral components, the feasibility of replacing them with short-stem humeral components, and the clinical outcomes associated with short-stemmed humeral components in shoulder arthroplasty.

Onlay versus inlay humeral components in reverse shoulder arthroplasty: A systematic review and meta-analysis

2021 ◽  
pp. 175857322110671
Author(s):  
Garrett R Jackson ◽  
Joshua Meade ◽  
Bradley L Young ◽  
David P Trofa ◽  
Shadley C Schiffern ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Meta Analysis ◽  
Reverse Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Forward Flexion ◽  
Scapular Fractures ◽  
Humeral Component ◽  
Significant Difference ◽  
Vas Scores

Background Advances have been made to the traditional inlay Grammont Reverse Shoulder Arthroplasty (RSA) design such as the onlay humeral component prosthesis. Currently, there is no agreement in the literature regarding the best option for the humeral component when comparing inlay and onlay designs. This review compares the outcomes and complications between onlay versus inlay humeral components for RSA. Methods A literature search was conducted using PubMed and Embase. Only studies reporting outcomes comparing onlay versus inlay RSA humeral components were included. Results Four studies with 298 patients (306 shoulders) were included. Onlay humeral components were associated with better external rotation (ER) ( p < 0.0001). No significant difference in forward flexion (FF) or abduction was found. Constant scores (CS) and VAS scores did not differ. Increased scapular notching was found in the inlay group (23.18%) versus the onlay group (7.74%) ( p = 0.02). Postoperative scapular fractures and acromial fractures did not differ. Conclusion Onlay and inlay RSA designs are associated with improved postoperative range of motion (ROM). Onlay humeral designs may be associated with greater ER and lower rate of scapular notching; however, no difference was found in Constant and VAS scores, so further studies are required to assess the clinical significance of these differences.

Mid-term radiological results of a cementless short humeral component in anatomical and reverse shoulder arthroplasty

2019 ◽  
Vol 101-B (5) ◽  
pp. 610-614 ◽  
Author(s):  
W. R. Aibinder ◽  
D. W. Bartels ◽  
J. W. Sperling ◽  
J. Sanchez-Sotelo
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Stress Shielding ◽  
Radiological Findings ◽  
Humeral Component ◽  
Bone Changes ◽  
The Mean ◽  
Shoulder Arthroplasties ◽  
Glenoid Loosening

Aims Shoulder arthroplasty using short humeral components is becoming increasingly popular. Some such components have been associated with relatively high rates of adverse radiological findings. The aim of this retrospective review was to evaluate the radiological humeral bone changes and mechanical failure rates with implantation of a short cementless humeral component in anatomical (TSA) and reverse shoulder arthroplasty (RSA). Patients and Methods A total of 100 shoulder arthroplasties (35 TSA and 65 RSA) were evaluated at a mean of 3.8 years (3 to 8.3). The mean age at the time of surgery was 68 years (31 to 90). The mean body mass index was 32.7 kg/m2 (17.3 to 66.4). Results Greater tuberosity stress shielding was noted in 14 shoulders (two TSA and 12 RSA) and was graded as mild in nine, moderate in two, and severe in three. Medial calcar resorption was noted in 23 shoulders (seven TSA and 16 RSA), and was graded as mild in 21 and moderate in two. No humeral components were revised for loosening or considered to be loose radiologically. Nine shoulders underwent reoperation for infection (n = 3), fracture of the humeral tray (n = 2), aseptic glenoid loosening (n = 1), and instability (n = 3). No periprosthetic fractures occurred. Conclusion Implantation of this particular short cementless humeral component at the time of TSA or RSA was associated with a low rate of adverse radiological findings on the humeral side at mid-term follow-up. Our data do not raise any concerns regarding the use of a short stem in TSA or RSA. Cite this article: Bone Joint J 2019;101-B:610–614.

The biomechanical effectiveness of tendon transfers to restore rotation after reverse shoulder arthroplasty: latissimus versus lower trapezius

2020 ◽  
pp. 175857322094625
Author(s):  
Kevin Chan ◽  
G Daniel G Langohr ◽  
George S Athwal ◽  
James A Johnson
Keyword(s):  
Internal Rotation ◽  
Shoulder Arthroplasty ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Pectoralis Major ◽  
Tendon Transfers ◽  
Humeral Component ◽  
Pectoralis Major Transfer ◽  
Lower Trapezius

Background The purpose of this biomechanical simulator study was primarily to compare latissimus dorsi to lower trapezius tendon transfers for active external rotation and the pectoralis major transfer for internal rotation after reverse shoulder arthroplasty. Secondarily, the role of humeral component lateralization on transfer function was assessed. Methods Eight rotator cuff deficient cadavers underwent reverse shoulder arthroplasty with an adjustable lateralization humeral component. Latissimus dorsi and lower trapezius transfers were compared for active external rotation restoration and pectoralis major transfer for internal rotation restoration. Internal rotation/external rotation torques were measured for each lateralization at varying abduction and internal rotation/external rotation ranges-of-motion. Results The lower trapezius transfer generated, on average, 1.6 ± 0.2 nm more torque than the latissimus dorsi transfer (p < 0.001). The internal rotation/external rotation torques of all tendon transfers decreased as abduction increased (p < 0.01). At 0° elevation, reverse shoulder arthroplasty humeral component lateralization had a significant positive effect on tendon transfer torque at 60° internal rotation and external rotation (p < 0.01). Discussion Both the lower trapezius and the latissimus dorsi tendon transfers were effective in restoring active external rotation after reverse shoulder arthroplasty; however, the lower trapezius generated significantly more torque. Additionally, the pectoralis major transfer was effective in restoring active internal rotation. All tendon transfers were optimized with greater humeral component lateralization.

scholarly journals Does Humeral Component Lateralization in Reverse Shoulder Arthroplasty Affect Rotator Cuff Torque? Evaluation in a Cadaver Model

2017 ◽  
Vol 475 (10) ◽  
pp. 2564-2571 ◽  
Author(s):  
Kevin Chan ◽  
Daniel G.G. Langohr ◽  
Matthew Mahaffy ◽  
James A. Johnson ◽  
George S. Athwal
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Humeral Component

scholarly journals Humeral component version in reverse shoulder arthroplasty affects impingement in activities of daily living

2016 ◽  
Vol 7 ◽  
pp. 84
Author(s):  
Xiang Chen ◽  
Andreas Kontaxis ◽  
Dan Choi ◽  
Julien Berhouet ◽  
Timothy Wright ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Shoulder Arthroplasty ◽  
Daily Living ◽  
Reverse Shoulder Arthroplasty ◽  
Humeral Component

scholarly journals Current Concepts in Humeral Component Design for Anatomic and Reverse Shoulder Arthroplasty

2021 ◽  
Vol 10 (21) ◽  
pp. 5151
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Computer Assisted ◽  
Optimal Plan ◽  
Humeral Component ◽  
Component Design ◽  
History Of ◽  
Preoperative Plan ◽  
Short Stems ◽  
Tissue Tension

The history of humeral component design has evolved from prostheses with relatively long stems and limited anatomic head options to a contemporary platform with short stems and stemless implants with shared instrumentation and the ability to provide optimal shoulder reconstruction for both anatomic and reverse configurations. Contemporary humeral components aim to preserve the bone, but they are potentially subject to malalignment. Modern components are expected to favorably load the humerus and minimize adverse bone reactions. Although there will likely continue to be further refinements in humeral component design, the next frontiers in primary shoulder arthroplasty will revolve around designing an optimal plan, including adequate soft tissue tension and providing computer-assisted tools for the accurate execution of the preoperative plan in the operating room.

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