title: Radiographic evaluation of short-stem press-fit total shoulder arthroplasty: short-term follow-up.
abstract: BACKGROUND
  Humeral loosening is an uncommon etiology for revision shoulder arthroplasty. We aimed to evaluate the radiographic and clinical outcomes of a short-stem press-fit humeral component after primary total shoulder arthroplasty.
  
  
  METHODS
  We reviewed our patient database, from January 2008 to December 2011, for primary total shoulder arthroplasties performed with a short-stem press-fit humeral component. Radiographs and clinical outcomes were evaluated in the immediate postoperative period and at the most recent follow-up, with at least 24 months of data for all patients.
  
  
  RESULTS
  There were 73 shoulders that met our inclusion criteria, but 4 underwent revision before 2 years' follow-up. Only 1 of these 4 was revised for aseptic humeral loosening. Sixty-nine shoulders had at least 24 months of radiographic follow-up, and 62 had radiographic and clinical follow-up. Of the 69 shoulders, 5 underwent revision for humeral loosening: 1 for aseptic loosening and 4 for infection. Two other shoulders with humeral loosening were asymptomatic, and the patients refused revision surgery. The overall revision rate for humeral loosening was 8.2% (6 of 73 shoulders). Radiolucent zones of any size were seen in 71.0%, with 8.7% of these shoulders identified as having humeral stems at risk of future loosening. Significant improvements were made in most of the measured clinical outcomes.
  
  
  CONCLUSIONS
  A high percentage of radiolucency was seen around the short-stem press-fit humeral components evaluated in this study at short-term follow-up. The overall rates of loosening and revision for the humeral implant examined in this study are higher than those noted in other recent studies evaluating press-fit stems. The cause of radiolucency and humeral loosening for this implant is not fully understood.
authors.affiliation: San Francisco Shoulder, Elbow, and Hand Clinic, San Francisco, CA, USA. Electronic address: dcasagra@gmail.com.
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Casagrande
authors.affiliation: San Francisco Shoulder, Elbow, and Hand Clinic, San Francisco, CA, USA.
authors.forename: Di L
authors.initials: DL
authors.lastname: Parks
authors.affiliation: San Francisco Shoulder, Elbow, and Hand Clinic, San Francisco, CA, USA.
authors.forename: Travis
authors.initials: T
authors.lastname: Torngren
authors.affiliation: San Francisco Shoulder, Elbow, and Hand Clinic, San Francisco, CA, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schrumpf
authors.affiliation: San Francisco Shoulder, Elbow, and Hand Clinic, San Francisco, CA, USA.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Harmsen
authors.affiliation: San Francisco Shoulder, Elbow, and Hand Clinic, San Francisco, CA, USA.
authors.forename: Tom R
authors.initials: TR
authors.lastname: Norris
authors.affiliation: San Francisco Shoulder, Elbow, and Hand Clinic, San Francisco, CA, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072228:Arthroplasty, Replacement, Shoulder / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011475:Prosthesis Failure / Q000209:etiology; D011859:Radiography; D012086:Reoperation; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D000072227:Shoulder Prosthesis / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Ascend; clinical outcomes; humeral loosening; press fit; radiolucency; short stem; total shoulder arthroplasty