On the Concerning Early Failure of a Short Stem Press-Fit Humeral Component.

Autor: La Banca V; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA; Instituto Brasil de Tecnologias da Saúde (IBTS) R. Visconde de Pirajá, 407/ suite 905, Rio de Janeiro RJ Brazil. Electronic address: labanca.vitor@gmail.com., Hall DJ; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA., Mowers CC; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA., Williams T; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA., Yi DJ; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA., Nicholson G; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA., Pourzal R; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA., Garrigues GE; Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL 60612, USA.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2024 Aug 01. Date of Electronic Publication: 2024 Aug 01.
DOI: 10.1016/j.jse.2024.05.058
Abstrakt: Introduction: Anatomic total shoulder arthroplasty (TSA) is a common surgical intervention for various shoulder pathologies, predominantly glenohumeral osteoarthritis. While generally considered safe and effective, complications remain a challenge. Short stem implants, aim to preserve bone stock and reduce complications. However, concerns about a specific short stem implant (Univers Apex; Arthrex, Naples, FL, USA) have surfaced due to high reported rates relatively early aseptic loosening.
Methods: This retrospective study analyzed 116 consecutive TSA patients with Univers Apex implants from 2004 to 2022. 15 revision cases were assessed for radiographic loosening, and explanted implants were examined for damage using a 0-3 scale. Histopathological analysis evaluated cellular responses to wear debris.
Results: Of the patients, 13% (15/116) required revision at 23.2 months on average. A distinct radiographic loosening pattern was identified, with humeral component subsidence and thinning of the proximal humeral cortex. Histopathology revealed a robust inflammatory response to wear debris, with a potential association between macrophage infiltration, hinge damage, and polyethylene wear.
Conclusion: This study reveals a notable rate of early aseptic humeral loosening with the Univers Apex short stem implant, emphasizing concerns raised in previous reports and providing a potential explanation for the high rate of early failure. Surgeons should exercise caution and closely monitor patients with this implant design.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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