Radiographic outcomes of the humeral stem after treating a proximal humerus fracture with an uncemented reverse total shoulder arthroplasty: a multicenter retrospective review.

Document Type

Article

Publication Date

5-4-2026

Publication Title

JSES international

Abstract

BACKGROUND: Reverse total shoulder arthroplasty (rTSA) for proximal humerus fractures is becoming more common. The aim of this study was to investigate the radiographic outcomes of uncemented rTSA for proximal humerus fractures and compare these outcomes based on 3 different implants.

METHODS: This was a retrospective review of patients treated with uncemented primary rTSA for acute proximal humerus fracture at 2 large healthcare institutions using one of 3 different humeral stem designs. Group A (n = 46) received a Zimmer TM stem, group B (n = 27) received a DJO Altivate stem, and group C (n = 18) received a Medacta stem for a total of 159 patients. Three independent reviewers assessed the most recent x-rays for 1) humeral subsidence, 2) humeral tilt, 3) humeral radiolucent lines, 4) humeral stem at risk for loosening, 5) osteolysis, 6) humeral stress shielding, 7) component failure, 8) spot welds, 9) scapular notching, and 10) tuberosity union.

RESULTS: The mean follow-up was 21 months (range, 6 months to 10 years). The average age at the time of surgery was 71.0 years old. Radiographic analysis showed group C (67%) was associated with significantly higher rates of stress shielding compared to group B (19%) and group A (6.5%) (

CONCLUSION: Overall, we found significant variability in radiographic performance, particularly regarding stress shielding and risk of stem loosening when evaluating radiographic outcomes of these 3 cementless humeral stem designs used in rTSA for proximal humerus fractures.

Volume

10

Issue

3

First Page

101674

DOI

10.1016/j.jseint.2026.101674

ISSN

2666-6383

PubMed ID

42063491

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