title: Clinical and radiographic results of cementless reverse total shoulder arthroplasty: a comparative study with 2 to 5 years of follow-up.
abstract: BACKGROUND
  Most studies of reverse total shoulder arthroplasty (RTSA) involve cemented humeral stems. To our knowledge, this is the first study to compare the results of cementless RTSA, using a porous-coated stem designed for uncemented fixation, with cemented RTSA.
  
  
  METHODS
  A prospective database of patients undergoing RTSA was retrospectively reviewed for patients with a diagnosis of cuff tear arthropathy or severe rotator cuff deficiency with minimum 2-year follow-up. Of these, 37 patients had cemented RTSA and 64 patients had cementless RTSA. Outcome measures included Constant-Murley scores, American Shoulder and Elbow Surgeons scores, visual analog pain scale scores, range of motion, patient satisfaction, and radiographic evidence of complication.
  
  
  RESULTS
  Compared with preoperative values, both cohorts demonstrated significant improvements (P < .01) in all functional scores, active forward elevation, and active internal rotation. There was no significant difference (P > .05) in comparing the changes in these values after surgery between the cemented and cementless cohorts. On radiographic evaluation, there was no evidence of loosening or humeral components "at risk" of loosening in either group. There was no significant difference (P = 1.0) in the incidence of humeral component radiolucent lines between the cemented and uncemented cohorts. There was no significant difference (P = .30) in the incidence of scapular notching between the cemented (n = 8) and uncemented (n = 10) cohorts.
  
  
  CONCLUSIONS
  Cementless fixation of a porous-coated RTSA humeral stem provides clinical and radiographic outcomes equivalent to those of cemented stems at minimum 2-year follow-up. With advantages such as simplified operative technique, no cement-related complications, greater ease of revision, and long-lasting biologic fixation, uncemented fixation may provide several benefits over cemented fixation.
authors.affiliation: Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, MI, USA. Electronic address: mwiater@beaumont.edu.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Wiater
authors.affiliation: Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, MI, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Moravek
authors.affiliation: Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, MI, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Budge
authors.affiliation: Department of Orthopaedic Research, Beaumont Health System, Royal Oak, MI, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Koueiter
authors.affiliation: Department of Radiology, Beaumont Health System, Royal Oak, MI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Marcantonio
authors.affiliation: Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, MI, USA.
authors.forename: Brett P
authors.initials: BP
authors.lastname: Wiater
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D001843:Bone Cements; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements
keywords: Reverse total shoulder arthroplasty; cuff tear arthropathy; porous-coated stem; rotator cuff deficiency; uncemented fixation