title: Functional and radiologic outcomes of uncemented reverse shoulder arthroplasty in proximal humeral fractures: cementing the humeral component is not necessary.
abstract: BACKGROUND
  Our aim was to determine the radiologic and functional outcomes of patients who underwent reverse shoulder arthroplasty (RSA) for proximal humeral fractures and to assess whether the uncemented humeral components put them at risk for early loosening and failure.
  
  
  METHODS
  Thirty-three patients were identified in our hospital database (January 2004-December 2012). Twenty patients were assessed using American Shoulder Elbow Surgeons (ASES) score, Constant Shoulder Score (CSS), and the Oxford Shoulder Score (OSS). Up-to-date shoulder radiographs were evaluated for evidence of radiologic loosening.
  
  
  RESULTS
  The mean follow-up period was 3.0 years (range, 2.5-7.8 years), and the mean age at the time of surgery was 76.5 years (range, 62-87 years). The mean ASES was 75.9 of 100 (range, 55-98.3), with a mean visual analog scale pain score of 2 of 10. The mean OSS was 42.5 of 48 (range, 35-48), and the mean CSS was 54.1 of 100 (range, 32-72). Upon radiographic assessment of the humeral component, 6 patients (30%) had 3 or more lucent zones, and 12 patients (60%) had a lucent zone measuring more than 2 mm in width; however, only 2 patients (10%) had 3 or more lucent zones measuring 2 mm or more in width and were identified as "at risk of loosening." No patients had tilt or subsidence of the humeral prosthesis.
  
  
  CONCLUSIONS
  Our study demonstrated satisfactory functional and radiologic outcomes of patients compared with other studies, suggesting that RSA is a good management option for elderly patients with these fractures. The uncemented nature of the humeral component did not result in early loosening or failure.
authors.affiliation: Department of Orthopaedic Surgery, North Shore Hospital (Waitemata District Health Board), Auckland, New Zealand. Electronic address: smdyoun@gmail.com.
authors.forename: Seung-Min
authors.initials: SM
authors.lastname: Youn
authors.affiliation: Department of Orthopaedic Surgery, North Shore Hospital (Waitemata District Health Board), Auckland, New Zealand.
authors.forename: Shaneel
authors.initials: S
authors.lastname: Deo
authors.affiliation: Department of Orthopaedic Surgery, North Shore Hospital (Waitemata District Health Board), Auckland, New Zealand.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Poon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000379:methods*; D001843:Bone Cements; D002484:Cementation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D001843:Bone Cements
keywords: Proximal humeral fractures; humeral prosthesis; loosening; lucency; radiological outcome; reverse shoulder arthroplasty; shoulder function; uncemented