This retrospective comparative study asks whether a trabecular titanium metaglene improves outcomes over a standard press-fit baseplate in reverse shoulder arthroplasty for elderly proximal humeral fractures. Thirty-two patients with Neer III-IV fractures were followed at a mean of 30.8 months. Outcomes measured included range of motion, abduction strength, VAS, QuickDASH, Constant score, and radiographic loosening.
When you plan RSA for a Neer III-IV fracture in an elderly, osteoporotic shoulder, baseplate fixation into poor cancellous bone is a real concern. This paper suggests a trabecular titanium metaglene may give better osseointegration and primary stability, translating into meaningfully better elevation, abduction, strength, and Constant score than a standard press-fit baseplate.
Remember why RSA is preferred over hemiarthroplasty here: function is less dependent on tuberosity healing and rotator cuff integrity. This cohort proves the point, with good function despite only 37.5% complete tuberosity healing.
Weigh the evidence carefully. This is Level III, retrospective, non-randomized, with only 16 patients per arm, and implant choice was driven by intraoperative surgeon judgment of bone quality, which introduces selection bias. The large effect sizes are encouraging but need confirmation in larger, longer, randomized studies before TT becomes a default choice in fracture cases.
This retrospective comparative study asks whether a trabecular titanium metaglene improves outcomes over a standard press-fit baseplate in reverse shoulder arthroplasty for elderly proximal humeral fractures. Thirty-two patients with Neer III-IV fractures were followed at a mean of 30.8 months. Outcomes measured included range of motion, abduction strength, VAS, QuickDASH, Constant score, and radiographic loosening.
When you plan RSA for a Neer III-IV fracture in an elderly, osteoporotic shoulder, baseplate fixation into poor cancellous bone is a real concern. This paper suggests a trabecular titanium metaglene may give better osseointegration and primary stability, translating into meaningfully better elevation, abduction, strength, and Constant score than a standard press-fit baseplate.
Remember why RSA is preferred over hemiarthroplasty here: function is less dependent on tuberosity healing and rotator cuff integrity. This cohort proves the point, with good function despite only 37.5% complete tuberosity healing.
Weigh the evidence carefully. This is Level III, retrospective, non-randomized, with only 16 patients per arm, and implant choice was driven by intraoperative surgeon judgment of bone quality, which introduces selection bias. The large effect sizes are encouraging but need confirmation in larger, longer, randomized studies before TT becomes a default choice in fracture cases.