A propensity matched cohort analysis: Cemented vs press fit humeral stem fixation in anatomic total shoulder arthroplasty

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-02-03 DOI:10.1016/j.jor.2025.02.003

Amogh I. Iyer, Ryan M. Dopirak, Louis W. Barry, Benjamin L. Brej, Akshar V. Patel, Erryk Katayama, Gregory L. Cvetanovich, Julie Y. Bishop, Ryan C. Rauck

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引用次数: 0

Abstract

Introduction

Historically, humeral stems were cemented for anatomic shoulder arthroplasty (aTSA). However, cementless, or press-fit, fixation has been increasingly used. This study aims to compare outcomes and revision rates between cemented and press-fit humeral stems.

Methods

Institutional records were searched to identify all patients who underwent aTSA with cemented humeral fixation or press-fit fixation between 2009 and 2021. A 3:1 propensity match based on age, sex, pre-op forward elevation and external rotation was conducted. Mean functional measurements were compared using a 2-Sample t-Test, ordinal variables via Wilcoxon-Mann Whitney test, and categorical variables via the Chi-squared test.

Results

There were 35 cemented humeral fixation shoulders matched with 105 humeral press-fit shoulders included in the final cohort. Both groups had similar characteristics at baseline regarding age, sex, body mass index, Charlson Comorbidity Index, mean follow-up, ROM, and strength measurements. Average age at surgery was 61.88 ± 6.68 years with an average follow-up time of 5.61 ± 2.86 years. Post-operatively, press-fit fixation demonstrated significant improvement in all ROM testing: external rotation (ER), forward elevation (FE), internal rotation (IR)-and all strength testing: ER, FE, and IR. Cement fixation demonstrated significant improvement in all ROM testing but only in FE strength testing. Inter-group post-op ROM and strength testing comparisons revealed superior external rotation (p = 0.007) and forward elevation (p = 0.047) ROM in the press-fit group with similar internal rotation ROM values and similar strength testing. There were higher revision rates in the cement fixation cohort (Cement: 11.4 % vs press-fit: 3.8 %; p = 0.036).

Conclusion

The results of this analysis showcase that press-fit fixation is a viable option for aTSA. Press-fit fixation shoulders had better ROM in terms of external rotation and forward elevation as well a better survival time to revision compared to cement fixation.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.