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General Orthopaedics

THE NON-CEMENTED HUMERUS: THE OPTIMAL HYBRID SOLUTION – AFFIRMS

Current Concepts in Joint Replacement (CCJR) – Spring 2015



Abstract

The humeral component has a long track record of a low rate of humeral loosening. Moreover, there are significant challenges associated with removal of a failed cemented component.

Throckmorton reviewed the results of 76 total shoulder arthroplasties for osteoarthritis with minimum two year follow-up. There were incomplete lucent lines in 5/76 stems. None of the stem were judged to be at risk for loosening. Matsen published on the outcome of 131 shoulder arthroplasties for osteoarthritis with minimum two year follow-up. In this series, there were no components with shift or tilt.

In addition to strong literature support for the use of an uncemented humeral component, revision of a cemented humeral component can be very difficult with a risk of significant destruction of the humerus.

The cortex of the humerus tends to be thin and removing the cement can be similar to trying to remove concrete from an ice cream cone.

Therefore, the extremely low rate of loosening and the challenges associated with cemented components makes the non-cemented component the ideal humeral solution.