Singh JA. J Shoulder Elbow Surg. 2011. doi:10.1016/j.jse.2011.06.015
Although the 20-year survival of humeral head replacements was reported as “excellent,” authors from the Mayo Clinic found in this study that obesity and younger age are risk factors for revision.
The study involved data prospectively collected from the Mayo Clinic Total Joint Registry, along with other institutional electronic databases. The team used Kaplan-Meier survival analysis to determine the revision-free survival rate of humeral head replacements at the 5-year, 10-year and 20-year marks. Age, gender, BMI, comorbidities, implant fixation, underlying diagnosis and other factors were all analyzed to determine their associations with risk of revision.
The study period spanned from 1976 to 2008, covering 1,359 patients with a mean age of 63 years and mean BMI of 28 kg/m² who underwent 1,431 shoulder humeral head replacements. Sixty percent of the implants were cemented, the authors noted.
The authors reported revision in 114 humeral head replacements, with respective 5-year, 10-year and 20-year implant survival rates of 93.6%, 90% and 85%. Older age was reported to be associated with a lower risk of revision, with higher BMI representing a higher risk of revision.
“Further studies should investigate the biologic rationale for these important associations,” the authors wrote. “Surgeons can discuss these differences in revision risk with patients, especially young obese patients.”