Evaluation of Humeral Stem and Glenosphere Fixation in Reverse Total Shoulder Arthroplasty: A Prospective, Randomized Clinical Trial With Two-Year Follow-Up

Description

The presentation discusses advancements in reverse total shoulder arthroplasty (RTSA), emphasizing its recognized benefits and growing use, alongside associated challenges such as implant loosening and the high revision burden. The speaker, Madeleine Van De Kleut, outlines the role of Radiostereometric Analysis (RSA) as a tool for tracking implant migration and its implications for long-term outcomes. A randomized clinical trial was conducted to compare the migration of different humeral stems (cemented vs. press-fit) and glenosphere designs (BIO-RSA vs. porous titanium-augmented) over two years postoperatively. Findings indicate significant differences in migration patterns, with press-fit stems exhibiting greater inferior subsidence compared to cemented stems. However, both fixation methods demonstrated overall stability after one year. Ultimately, while press-fit and standard length cemented stems yielded comparable clinical outcomes, further long-term follow-up is necessary to assess loosening risks. The efficacy of glenosphere lateralization techniques was also highlighted, showing no significant differences in patient-reported outcomes across different groups.

DOI: 10.1302/3114-220827

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