Cement-within-cement technique in revision reverse total shoulder arthroplasty: complications, reoperations, and revision rates at 5-year mean follow-up

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dc.catalogadorpva
dc.contributor.authorMarinis Acle, Rodrigo Ignacio de
dc.contributor.authorSperling, John W.
dc.contributor.authorMarigi, Erick M.
dc.contributor.authorVelasquez Garcia, Ausberto
dc.contributor.authorWagner, Eric R.
dc.contributor.authorSanchez-Sotelo, Joaquin
dc.date.accessioned2025-04-15T19:48:03Z
dc.date.available2025-04-15T19:48:03Z
dc.date.issued2025
dc.description.abstractBackground: Revision reverse total shoulder arthroplasty (rTSA) of a previously cemented humeral component is challenging. In hip arthroplasty, the cement-within-cement (CwC) technique has been well described as an effective option. However, for shoulder arthroplasty there remains a paucity of data investigating this technique. The purpose of this study was to determine the mid-term outcomes of patients who underwent a revision rTSA utilizing the CwC for management of the humeral component. Methods: Between 2005 and 2021, 68 revision rTSA using the CwC technique with a minimum of 2 years clinical follow-up were identified from a single institution joint registry database. Revised implants consisted of 38 (55.9%) hemiarthroplasties, 22 (32.4%) anatomic total shoulder arthroplasties, and 8 (11.8%) rTSA. A total of 12 (17.6%) shoulders required an osteotomy (corticotomy or window) to assist with extraction of the cemented stem. The mean follow-up after revision was 5.4 years (range, 2-16 years). Surgical complications, reoperations, revisions, and implant survivorship were assessed. Results: Of the 12 shoulders that required an osteotomy for component removal, 11 (91.7%) were healed. At final follow-up, the overall complication rate was 26.9%. The most common complication was fracture or fragmentation of the greater tuberosity (20.6%, n = 13) with 10 (76.9%) cases showing signs of healing at final follow-up. The overall survivorship free of revision surgery was 88.2% at 2 and 80.9% at 5 years, respectively. The most frequent causes of re-revision surgery were aseptic glenoid component loosening (n = 4) and instability (n = 4), with only 2 (2.9%) patients developing humeral component loosening (at 2 and 5 years, respectively). Male sex was associated with an increased risk of revision surgery (hazard ratio [HR], 3.52 [95% confidence interval [CI] 1.22-10.18]; P = .02) and complications (HR, 3.56 [95% CI, 1.40-9.07]; P = .008). The grade of postoperative lucent lines at the humerus (HR, 1.35 [95% CI, 1.04-1.74]; P = .02) and glenoid (HR, 1.59 [95% CI, 1.22-2.10]; P = .001) also correlated with an increased risk of re-revision surgery. Conclusion: The CwC technique is a reliable option for revising previously cemented humeral components in revision rTSA. Although a low rate of humeral component loosening was observed, higher rates of complications and re-revision surgery were observed over time secondary to aseptic glenoid component loosening and instability, which are not directly related to CwC technique but to revision surgery in general.
dc.fechaingreso.objetodigital2025-04-15
dc.format.extent6 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1016/j.xrrt.2024.08.006
dc.identifier.issn2666-6391
dc.identifier.scopusidSCOPUS_ID:85204679283
dc.identifier.urihttps://doi.org/10.1016/j.xrrt.2024.08.006
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/103311
dc.information.autorucEscuela de Medicina; Marinis Acle, Rodrigo Ignacio de; 0000-0003-1888-8928; 237996
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido completo
dc.publisherElsevier Inc.
dc.revistaJSES Reviews, Reports, and Techniques
dc.rightsacceso abierto
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectCement within cement
dc.subjectCemented humeral component
dc.subjectImplant survivorship
dc.subjectLevel IV
dc.subjectPostoperative complications
dc.subjectRetrospective Case Series
dc.subjectReverse total shoulder arthroplasty
dc.subjectRevision shoulder arthroplasty
dc.subjectRevision shoulder arthroplasty
dc.subjectCemented humeral component
dc.subjectReverse total shoulder arthroplasty
dc.subjectImplant survivorship
dc.subjectPostoperative complications
dc.subjectCement within cement
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCement-within-cement technique in revision reverse total shoulder arthroplasty: complications, reoperations, and revision rates at 5-year mean follow-up
dc.typeartículo
dc.volumen5
sipa.codpersvinculados237996
sipa.trazabilidadORCID;2025-03-03
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