Abstract
Background
The need for revision shoulder arthroplasty is progressively increasing. Removal of a well-fixed humeral standard stem during revision shoulder arthroplasty may require techniques such as humeral osteotomy, which may contribute to longer surgical time, loss of humeral bone stock and lower clinical outcomes; however, the incidence and influence of stem design remain incompletely defined.Purpose
This study aimed to determine the incidence of humeral osteotomy during revision shoulder arthroplasty of a single uncemented, standard-length, low-filling-profile humeral stem design with a metaphyseal coating and a smooth diaphyseal stem (Arrow, FH Orthopedics).Methods
In a retrospective design, all revision shoulder arthroplasty which require stem revision performed at three high-volume centres between 2000 and 2023 were evaluated. Patients were included if in the primary surgery an uncemented, standard-length, low-filling-profile humeral stem design (Arrow, FH Orthopedics) was used. Cemented stems were excluded from the analysis. Demographic data, type of primary surgery (anatomic total shoulder arthroplasty (aTSA), reverse total shoulder arthroplasty (rTSA) or hemiarthroplasty (HA), reason for revision and need for humeral osteotomy were recorded. The primary outcome was the need for humeral osteotomy during revision surgery. Univariate logistic regression analyses were performed to evaluate possible risk factors.Results
Humeral osteotomy was required in 6% (4/64) of revisions. Patient age, sex, type of primary Implant and revision aetiology were not associated with increased risk for humeral osteotomy (P > 0.05).Conclusion
Humeral osteotomy was required in approximately 6% of revision procedures. An uncemented, standard-length stem with a low-filling-profile design could explain the very low rates of humeral osteotomy compared to literature data.