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Abstract
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Background :
The increase in the number of first-line shoulder arthroplasties has led in recent years to an increase in the number of shoulder replacement procedures. Revision surgery is technically more difficult, with often more consequent complications. Few data are published on the occurrence and risk factors of these complications.
Objective:
The objective is to evaluate 1) the prevalence of intraoperative humeral fractures (FHP) during prosthetic shoulder revision and 2) to identify these risk factors.
Materials and Methods :
Between 2008 and 2020; 89 patients having undergone shoulder prosthesis revision were included in a monocentric retrospective study. In all of these patients, the glenoid and/or humeral implant had been changed. Five groups of patients were enrolled:
1. fracture prevalence in the study population (10/89)
2. fracture occurrence by age (more than 70 years=3 and less than70 years=7)
3. fracture occurrence by infection (7 patients)
4. fracture occurrence by stem length (10 long and 0 short stems)
5. fracture occurrence by cement (6 cemented and 4 uncemented stems).
Results :
Out of 89 patients with an average mean age of 69.5 years (28-99), 10 fractures (11.2%) occurred at revision. All fractures (100%) occurred during stem extraction (long (n=10), short (n=0), cemented (n=6) or uncemented (n=4)). The risk of intraoperative fracture was associated with long primitive stem (p=0.0001) and statistically insignificant at advanced age (p=0.41); infection of the primitive prosthesis (p=0.07); female sex (p=0.58) and cemented primitive stem (p=0.378).
Conclusions :
Humeral fracture is a frequent phenomenon during shoulder prosthesis revision. The main favoring factor was mainly the length of the primitive stem.
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