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Suture cerclage for stabilizing the humeral shaft during shoulder arthroplasty

Authors :
Blake A. Eyberg
Reuben Gobezie
Samuel M. Harmsen
J. Brock Walker
Patrick J. Denard
Evan Lederman
Source :
JSES International, Vol 4, Iss 3, Pp 688-693 (2020), JSES International
Publication Year :
2020
Publisher :
Elsevier BV, 2020.

Abstract

Background: In shoulder arthroplasty, cerclage fixation techniques are used to stabilize osteotomies, fractures, and allografts. Fixation techniques including cerclage with metal and polymer cables have been described. The purpose of this study was to evaluate suture cerclage fixation of the humeral shaft during shoulder arthroplasty. Materials and methods: Shoulder arthroplasty cases performed from 2012-2017 by 3 fellowship-trained shoulder arthroplasty surgeons were reviewed. Cases in which suture cerclage was used for osteotomy, fracture, or allograft fixation were identified. Demographic data, indications, implant types, fixation techniques, and complications were reviewed. Postoperative radiographs were analyzed for union, component loosening, and loss of fixation. American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation scores were collected preoperatively and postoperatively. Results: A total of 27 patients (3 primary and 24 revision cases) with a mean age of 69.6 years (range, 28-88 years) were available for follow-up at a mean of 12.6 months (range, 0.8-42.3 months) postoperatively. Humeral osteotomy alone was performed in 15 cases. Allograft alone was used in 1 case. Both allograft and osteotomy were used in 6 cases. Complications occurred in 3 patients (11%), comprising 1 postoperative periprosthetic fracture and 2 prosthetic joint infections; all required further surgery. Radiographs at final follow-up showed healing of all osteotomies and fractures. No hardware failure or implant loosening occurred. The mean postoperative American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation scores were significantly improved (α = .05) compared with preoperative scores, from 21.4 to 44.5 (P = .002) and from 26.7 to 74.1 (P < .001), respectively. Conclusion: Suture cerclage is safe and effective for humeral fixation in shoulder arthroplasty.

Details

ISSN :
26666383
Volume :
4
Database :
OpenAIRE
Journal :
JSES International
Accession number :
edsair.doi.dedup.....946f8e56648ee926bf7d922bbc96a2b6
Full Text :
https://doi.org/10.1016/j.jseint.2020.03.002