Early retrospective experience reporting short-term outcomes of a cementless modular diaphyseal stem in complex revision reverse total shoulder arthroplasty.

BACKGROUND

Cementless modular diaphyseal press-fi t stems (MDS) development has provided an alternative to traditional cemented fixation in extensive humeral bone loss, achieving stability and reducing cement-related complications in early follow-up.

OBJECTIVE

To evaluate clinical and radiographic outcomes of revision rTSA using the cementless press-fit MDS. Assess early postoperative survival and the effectiveness of this fixation strategy in complex revision cases.

METHODS

Retrospective study (January2023-May2024), including 14 shoulders undergoing revision rTSA using MDS and a minimum 24-month follow-up. Functional outcomes were assessed using Constant, ASES, ADLEIR, VAS, and SST scores, and range of movement (ROM). Radiographic assessments determined fixation stability and loosening.

RESULTS

Mean follow-up was 30.1 months. Indications for surgery included infection (n=8), periprosthetic fracture (n=5), and failed hemiarthroplasty (n=1). Postoperative ROM improved, with mean forward elevation of 114.6°, abduction of 95.7°, and external rotation of 25.4°. Functional scores also increased (Constant: 36.6→55.9; ASES: 31.4→61; VAS: 7.9→2.8). No implant loosening, instability, or postoperative fractures were recorded. Two acute infections, successfully treated without revision and one asymptomatic non-traumatic humeral stem disengagement.

CONCLUSION

Cementless modular diaphyseal press-fi t stems demonstrated satisfactory early clinical and radiographic outcomes in complex revision rTSA and may represent a valuable option when proximal metaphyseal fixation cannot be achieved. Further studies with larger cohorts and longer follow-up are required to confirm their long-term durability and performance.