January 30, 2018
1 min read

Anatomic press-fit short stem linked with significant clinical improvements after TSA

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Patients who underwent total shoulder arthroplasty with an anatomic press-fit short stem had significant clinical improvements, with few complications and minimal radiographic changes at short-term follow-up, according to results published in The Journal of Shoulder and Elbow Surgery.

Christopher M. Kilian, MD, and colleagues assessed shoulder function scores, active mobility measurements and radiographs among 118 patients who underwent total shoulder arthroplasty (TSA) with a minimum 2-year follow-up. Of the TSAs included, 85 patients had a grit-blasted short stem (Aequalis Ascend, Wright Medical) and 33 had short stems with proximal porous coating (Aequalis Ascend Flex, Wright Medical).

From preoperative measures to final follow-up, results showed significant improvements in all shoulder function scores and active mobility measurements. Although no patients experienced stem loosening at minimum 2-year follow-up, researchers found gross loosening of humeral components in three patients with grit-blasted stems before 1 year. Of these, two required revision.

According to results, 5.9% of patients had radiolucent lines around the humeral component without evidence of loosening and 9.3% of patients had osseous resorption at the medial cortex. Researchers noted no patients in the proximal porous-coating group had radiolucent lines vs. 8.2% of patients in the grit-blasted group.

“The use of an anatomic press-fit short stem is becoming more prevalent among shoulder surgeons. Significant benefits include preservation of bone stock and ease of humeral revision surgeries,” Kilian told Healio.com/Orthopedics. “In our cohort of patients, the only instances of loosening occurred in those lacking proximal porous coating on the stem. This coating likely improves ingrowth, thus decreasing any instances of loosening. Surgeons should understand that the use of short stems are safe and effective, showing significant improvements in clinical outcomes consistent with the use of standard length stems.” – by Casey Tingle

Disclosures: Kilian reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.