Clin Orthop Surg.  2024 Aug;16(4):602-609. 10.4055/cios23397.

Cemented Versus Uncemented Reverse Shoulder Arthroplasty Treatment of Proximal Humerus Fractures: National Shoulder Arthroplasty Data from Türkiye

• Orhan
• Kaya
• Bingöl
• Sarikaya B
• Ayvali MO
• Ata N
• Ülgü MM
• Birinci
• Karaaslan F
• Basat H
• On behalf of the Ministry of Health Shoulder and Elbow Surgery Scientific Research Group

• KMID: 2558060
• DOI: http://doi.org/10.4055/cios23397

Abstract

Background
This study evaluated national trends in cemented and uncemented reverse shoulder arthroplasty (RSA) for proximal humerus fractures using a comprehensive national surgical database. This study aimed to compare RSA used in the treatment of proximal humerus fractures with the literature and to determine the country's trend.
Methods
A cross-sectional study was conducted using the health records of individuals aged ≥ 18 years who underwent RSA for proximal humerus fractures between 2016 and 2022. Patients were divided into cemented and uncemented groups, and demographic data (age, sex), duration of hospital stay, transfusions, revisions, mortality, and Charlson Comorbidity Index (CCI) scores were analyzed.
Results
A total of 618 cemented RSA and 1,364 uncemented RSA procedures were reviewed. Patients who underwent cemented RSA were significantly older than those who had uncemented RSA (p = 0.002). Transfusion rates were higher in the cemented RSA group (p = 0.006). The frequency of revision surgery was 6.1%. Younger age and male sex were associated with revision (p < 0.001). CCI scores were higher among transfused patients than non-transfused patients (p < 0.001). The incidence of cemented RSA was 11.7% and 49% in 2016 and 2022, respectively. Differences were found among hospital types and geographical regions.
Conclusions
While cemented RSA has been gaining attention and increased application in recent years for proximal humerus fractures, uncemented RSA still predominates. The choice between these 2 methods is largely influenced by regional and hospitallevel factors. The type of RSA and high CCI scores were found to have no significant impact on the risk of surgical revision.

Keyword

Proximal humerus fracture; Reverse shoulder arthroplasty; Cement; Charlson Comorbidity Index; National trends