As per a study published in ‘Journal of Shoulder and Elbow Surgery’, the first-generation cemented modular and the second-generation monolithic humeral stem implant were found to have comparable clinical outcomes in reverse total shoulder arthroplasty (RSA). Also, there was a noteworthy decrease in the occurrence of radiographic loosening and requirement for revision with monolithic stem primarily utilizing press fit fixation than cemented stem.

The outcomes, revisions, and complications between a first-generation cemented and a second-generation monolithic, chiefly uncemented humeral implant in RSA with 135-degree neck-shaft angle and changing degrees of metallic glenosphere offsets were examined in this study by R. Allen Gorman et al.

The patients undergoing RSA from 2004-2014 were retrospectively evaluated with a first-generation cemented modular humeral implant (comprising of 400 patients, Group 1) or second-generation monolithic humeral stem (comprising of 231 patients, Group 2), with minimum 2-year clinical and radiographic follow-up.

As found (Table 1 A and B), both groups had similar improvement of clinical outcomes (ASES +30 points versus +34 points) with improvements in all planes of motion.

Table 1 A and B: Pre- and postoperative patient-reported outcome measures and range of motion measurements at 2+ years in Group 1 and Group 2; p value <0.0001

The occurrence of humeral loosening for the cemented group was 3.6%, then 0.4% in the uncemented group. All in all, the revision was observed in 28 shoulders treated with cementing method (4.0%) and 6 patients treated by press-fit method (1.5%). Rate of postoperative acromial fractures within the first year was 3.4% in the cemented group and 1.8% in the uncemented group.