• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.245-251
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• 2023

Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair. Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures. Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75). Conclusions: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores. Level of evidence: III.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.4
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• pp.152-162
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• 2000

Purpose : To verify radiological changes of limb salvage operation using tumor prosthesis. Materials and Methods : Sixty-nine cases which used tumor prosthesis were reviewed. They have been followed up for average four years and nine months. We evaluated radiographs by ISOLS(International Symposium On Limb Salvage) radiological implants evaluation system immediate postoperatively, at postoperative 1 year and last follow-up. After converting 'excellent, good, fair, poor' to '4, 3, 2, 1' for stastical analysis, data were analyzed according to the use of cement, anatomical sites, diagnosis implant designs and age (<20 year vs. ${\geq}$20 year) using t-test and ANOVA. Results : The outcomes of cemented type prostheses were superior in remodelling and interface but inferior in anchorage. The scores of proximal femur and distal tibia were worse in bone remodelling. Osteosarcoma group had lower scores in anchorage and implant articular problem. There were no significant differences according to four different implant designs and age. Conclusion : In the intermediate term follow-up radiological evaluation, cemented type prosthesis were better in the aspects of bony resorption and osteolysis, and cementless one in anchorage. Distal femur and proximal tibia have higher scores in bony resorption, and osteosarcoma was worse tumor entity in anchorage and articular problem, and chemotherapy may be the cause.