A 135° short inlay humeral stem leads to comparable radiographic and clinical outcomes compared with a standard-length stem for reverse shoulder arthroplasty
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Notice bibliographique
Résumé
BackgroundHumeral stem length in reverse total shoulder arthroplasty (RTSA) has decreased in recent years in an attempt to preserve more bone and facilitate stem removal in the revision setting. The purpose of this study was to compare the clinical and radiographic outcomes of a short- to standard-length stem RTSA. The authors hypothesized that there would be no difference in radiographic or clinical outcomes at short-term follow-up.MethodsPatients who underwent RTSA using a press-fit standard- or short-length humeral component with a consistent geometry (Univers Revers, or Revers Apex; Arthrex, Inc., Naples, FL, USA) were evaluated in a multicenter retrospective review. The minimum clinical follow-up was 2 years. Immediate postoperative radiographs were used to assess initial alignment and filling ratios. In addition, radiographs at 2 years were evaluated for signs of stress shielding and/or loosening. Clinical outcome scores and range of motion were evaluated at the final follow-up and compared between groups.ResultsA total of 220 patients with short-stem RTSA and 357 patients with standard-length stem RTSA were analyzed. There was no difference in baseline function between short- and standard-length stem patients. Patients in the short stem group had higher postoperative American Shoulder and Elbow Surgeons (84.6 vs. 80.8; P = .014) and Western Ontario Osteoarthritis of the Shoulder (86.5 vs. 82.7; P = .025). Patients in the short stem group also had greater postoperative active forward flexion (139° vs. 132°; P = .003) and internal rotation with the arm at 90° of abduction (43° vs. 32°; P < .001) than patients in the standard-length group. Radiographically, there was a higher metaphyseal (P = .049) and diaphyseal (P < .001) fill ratio in the short stem group, although there was no difference in postoperative alignment, radiographic signs of loosening, or revision for loosening between groups (all P > .05).ConclusionA short inlay stem leads to comparable radiographic findings and revision-free survival compared with a standard-length stem when placed with a press-fit technique for RTSA. Clinical outcomes are also equivalent or slightly improved with a short stem compared with a standard-length stem. Humeral stem length in reverse total shoulder arthroplasty (RTSA) has decreased in recent years in an attempt to preserve more bone and facilitate stem removal in the revision setting. The purpose of this study was to compare the clinical and radiographic outcomes of a short- to standard-length stem RTSA. The authors hypothesized that there would be no difference in radiographic or clinical outcomes at short-term follow-up. Patients who underwent RTSA using a press-fit standard- or short-length humeral component with a consistent geometry (Univers Revers, or Revers Apex; Arthrex, Inc., Naples, FL, USA) were evaluated in a multicenter retrospective review. The minimum clinical follow-up was 2 years. Immediate postoperative radiographs were used to assess initial alignment and filling ratios. In addition, radiographs at 2 years were evaluated for signs of stress shielding and/or loosening. Clinical outcome scores and range of motion were evaluated at the final follow-up and compared between groups. A total of 220 patients with short-stem RTSA and 357 patients with standard-length stem RTSA were analyzed. There was no difference in baseline function between short- and standard-length stem patients. Patients in the short stem group had higher postoperative American Shoulder and Elbow Surgeons (84.6 vs. 80.8; P = .014) and Western Ontario Osteoarthritis of the Shoulder (86.5 vs. 82.7; P = .025). Patients in the short stem group also had greater postoperative active forward flexion (139° vs. 132°; P = .003) and internal rotation with the arm at 90° of abduction (43° vs. 32°; P < .001) than patients in the standard-length group. Radiographically, there was a higher metaphyseal (P = .049) and diaphyseal (P < .001) fill ratio in the short stem group, although there was no difference in postoperative alignment, radiographic signs of loosening, or revision for loosening between groups (all P > .05). A short inlay stem leads to comparable radiographic findings and revision-free survival compared with a standard-length stem when placed with a press-fit technique for RTSA. Clinical outcomes are also equivalent or slightly improved with a short stem compared with a standard-length stem.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle