Hombros con prótesis reversas totales- aflojamiento humeral en una artroplastia primaria total reversa de hombro por artropatia del manguito rotador

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Reverse total shoulders – humeral loosening in primary RSA for cuff tear arthropathy

Este artículo es originalmente publicado en:



Gilot G1, Alvarez-Pinzon AM2, Wright TW3, Flurin PH4, Krill M1, Routman HD5, Zuckerman JD6.

J Shoulder Elbow Surg. 2015 Oct;24(10):1555-9. doi: 10.1016/j.jse.2015.02.007. Epub 2015 May 7.
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Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.



The reverse total shoulder arthroplasty (RTSA) has been used in the treatment of complex shoulder problems. The incidence of aseptic loosening of the humeral component has not been previously reported.


This is a multicenter, retrospective, blinded, case-control radiographic review of 292 patients to determine the rate of humeral stemloosening. There were 177 cemented and 115 press-fit humeral components. Radiographs were critiqued for radiolucent lines adjacent to the humeralstem based on the method described by Gruen et al.


The overall rate of loosening was 0.74%. No radiographic loosening occurred in the press-fit group (115 stems). In the cemented group (177 stems), 2 shoulders (1.18%) were identified with radiographically loose stems. No loosening occurred in the press-fit group. No statistically significant difference was found in humeral stem loosening when the press-fit group and the cemented group were compared (P = .198).


Our study indicates the cemented or press-fit RTSA system will result in a low incidence of radiolucent lines and radiographicloosening. Compared with historical survivorship of conventional anatomic total shoulder arthroplasty, RTSA shows a lower rate of radiographic stemloosening at a mean of 38.46 months.


The RTSA has a low incidence of humeral stem loosening at midterm. These results underscore the importance of careful selection of patients to provide the benefits of this surgical technique. Press-fit fixation may provide a lower risk to stem loosening.

Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.


Reverse shoulder arthroplasty; failed shoulder replacement; humeral fixation; radiographic stem loosening; satisfactory outcome

[PubMed – in process]