ArticleJSES international2026
Do uncemented humeral components perform better than cemented humeral components in reverse total shoulder arthroplasty for acute proximal humerus fracture? A New Zealand Joint Registry study.
Article in JSES international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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Authors and funding
6 authors.
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Abstract
Background: Reverse total shoulder arthroplasty (rTSA) is increasingly used in unreconstructible and comminuted proximal humerus fractures. There is ambiguity as to whether uncemented or cemented humeral components (stems) have better survival and patient-reported outcome measures in this context. The aim of this study was to compare implant survival, risk of revision, reason for revision, and functional outcomes between cemented and uncemented stems for rTSA performed for acute proximal humerus fractures. Methods: Prospectively collected data from the New Zealand Joint Registry, a national database with capture >95%, were used to compare the survival rates and Oxford Shoulder Scores of rTSA performed for trauma (trauma rTSA) using cemented or uncemented stems between January 2002 and December 2024. Reason for revision and patient demographics were recorded. Revision rates (rates per 100 observed component years) and functional outcomes (Oxford Shoulder Score at 6-month and 5-year follow-up) were compared using a multivariate Cox proportional hazards regression model and adjusted by age, sex, American Society of Anesthesiologists class, and surgeon volume of rTSA per year. Results: Over the 22-year study period, 843 rTSA procedures were performed for acute proximal humeral fracture representing 4,668 component years. Of these trauma rTSA procedures, 326 utilized a cemented stem (cemented trauma rTSA) and 517 utilized an uncemented stem (uncemented trauma rTSA). The number of revisions per 100 component-years for cemented trauma rTSA was 0.64, compared to 0.36 for uncemented trauma rTSA. This difference was not statistically significant ( Conclusion: In the context of increasing use of rTSA for acute proximal humerus fractures, revision rates and patient-reported outcomes are similar between cemented and uncemented humeral stems. Uncemented humeral components are therefore an acceptable first-line treatment for proximal humerus fractures in appropriate patients.
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