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Reverse shoulder arthroplasty for proximal humeral fracture in the elderly. Cemented or uncemented stem?

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The purposes of this study were to compare functional outcomes, radiographic stem changes and complication rate in patients with proximal humeral fractures operated with cemented or uncemented RSA.


Retrospective review of 68 primary RSAs in PHF, 45 cemented/23 uncemented. Functional outcomes were evaluated according to constant, ASES scales and the range of motion (ROM). Radiographic assessment was performed at a minimum of two years post-operatively.


The mean follow-up cemented/uncemented was 37.8/26.5 months (p = .04) and the mean age 78/80 years old (p = .09). The functional outcome and range of movement were equivalent in the two groups except for the forward flexion that was significantly higher in the cemented group (p = .03). Stress shielding was seen in 30.4% of uncemented group and none in the cemented. Anatomic tuberosity healing was significantly higher with uncemented components compared with cemented components (64% vs 91%, p = .02). Cemented stems had radiolucent lines with a width of 2 mm or more in three or more Gruen zones in 9% vs 0% in the uncemented group and an evident change in the stem position was present in 4% vs 0% in the non-cemented group.


At mid-term follow-up, no differences in functional outcomes were detected depending on the stem fixation technique. Cemented stems, however, have a complication rate (including stem loosening) significantly higher than press-fit stems.

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Correspondence to Yaiza Lopiz.

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Institutional Review Board (IRB) “Ethics Committee for Clinical Research” (CEIC) from Clínico San Carlos Hospital (Madrid, Spain) approve the present study (19/418-E_TFG).

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Consent to publish and consent to participate were obtained from all individual participants included in the study.

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Lopiz, Y., García-Fernandez, C., Vallejo-Carrasco, M. et al. Reverse shoulder arthroplasty for proximal humeral fracture in the elderly. Cemented or uncemented stem?. International Orthopaedics (SICOT) 46, 635–644 (2022).

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