Evidence map›Paper›PMID 37607863›Full record

ArticleClinics in shoulder and elbow2023

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

Troy Li, Kenneth H Levy, Akiro H Duey, Akshar V Patel, Christopher A White, Carl M Cirino, Alexis Williams, Kathryn Whitelaw, Dave Shukla, Bradford O Parsons and 2 more

Abstract read
In one paragraph

Article in Clinics in shoulder and elbow, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Troy LiDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Kenneth H LevyDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Akiro H DueyDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Akshar V PatelDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Christopher A WhiteDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Carl M CirinoDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Alexis WilliamsDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Kathryn WhitelawDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Dave ShuklaDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Bradford O ParsonsDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Evan L FlatowDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Paul J CagleDepartment of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor 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.

methodsThis 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.

resultsOne 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).

conclusionsIn 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.

Indexed as

CementedLong-term outcomesPress-fitReplacement arthroplastyShoulder

Identifiers

PMID37607863
PMCPMC10497929

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.