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Impaction autografting proved to be secure, bone-preserving method for shoulder arthroplasty
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Use of impaction autografting for humeral component fixation in anatomic shoulder arthroplasty proved to be a secure, durable and bone-preserving option, according to results.
To assess subsidence, researchers evaluated the initial postoperative radiographs and minimum 2-year follow-up radiographs of 286 primary anatomic shoulder arthroplasties (65% of patients were male). During the study, patients either received the monoblock Humeral Replacement Prosthesis with a chrome cobalt stem, which was used from 1995 to 2003, or the modular Global Advantage prosthesis with a geometrically similar titanium stem, which was used from 1995 to 2012, (both from DePuy Synthes).
Overall, 50% of shoulders underwent total shoulder arthroplasty and 50% underwent a ream-and-run procedure or hemiarthroplasty. Researchers noted 6.6% of stems subsided, of which 15 cases occurred in prosthesis implanted before July 1999 and four occurred after this date. Results showed a higher subsidence rate among patients who received the Humeral Replacement Prosthesis vs. the Global Advantage prosthesis, both during the entire study period and the period up to July 1999. A higher risk of subsidence was also associated with patients who underwent total shoulder arthroplasty vs. hemiarthroplasty, researchers found.
According to results, the Global Advantage prosthesis had a 5-year survival rate of 98.5% vs. 88.5% for the Humeral Replacement Prosthesis. In all seven periprosthetic zones, researchers noted patients who received the Global Advantage stem had lower rates of radiolucencies of 2 mm or thicker. At an average of 6.2 years after the index surgery, 8.3% of shoulders underwent revision. – by Casey Tingle
Disclosures: Lucas reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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