Value comparison of humeral component press-fit and cemented techniques in reverse shoulder arthroplasty

被引:11
作者
Berglund, Derek D. [1 ]
Mijic, Dragomir [1 ]
Law, Tsun Yee [1 ]
Kurowicki, Jennifer [1 ,2 ]
Rosas, Samuel [1 ,3 ]
Levy, Jonathan C. [1 ]
机构
[1] Holy Cross Orthoped Inst, Ft Lauderdale, FL 33334 USA
[2] Seton Hall Univ, Sch Hlth & Med Sci, S Orange, NJ 07079 USA
[3] Wake Forest Univ, Bowman Gray Sch Med, Winston Salem, NC USA
关键词
Reverse shoulder arthroplasty (RSA); press fit; cemented; procedure value index (PVI); value; cost; SST; radiographic outcomes; STEM; REPLACEMENT; FRACTURES; OUTCOMES; FIXATION;
D O I
10.1016/j.jse.2018.08.015
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Press-tit humeral fixation for reverse shoulder arthroplasty (RSA) has been shown to have loosening rates and outcomes similar to a cemented technique: however. increased value has not been reported. The purpose of this study was to determine whether the press-fit technique could improve the value of RSA using the procedure value index (PVI). Methods: Primary RSA patients with complete hospitalization cost data. preoperative and minimum 2-year postoperative Simple Shoulder Test (SST) scores, and postoperative satisfaction were included. The PVI was calculated as improvement in the SST score (in units of minimal clinically important difference) divided by total cost and normalized. Itemized cost data were obtained from hospital financial records and categorized. Radiographic complications, infections. and revisions were noted. Comp:uisons were made between the press-fit and cemented RSA cohorts. Results: A total of 176 primary RSA patients (83 cemented and 93 press fit) met the inclusion criteria (mean follow-up period, 44.6 months). Surgical indications (except failed rotator cuff repair), baseline SST scores, and demographic characteristics were similar. The calculated minimal clinically important difference for the SST score was 3.98. The average PVI was significantly greater in the press-fit cohort (1.51 vs 1.03, P < .001), representing a 47% difference. SST score improvement was not significantly different (P = .23). However, total hospitalization costs were significantly lower for the press-fit cohort ($10,048.89 v s $13,601.14: P<.001). Conclusion: Use of a press-fit technique led to a 47% increase in value over a cemented technique. This appeared to be a function of decreased total costs rather than increased outcome scores. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
引用
收藏
页码:496 / 502
页数:7
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