Greater Tuberosity Healing Rate and Clinical Results Following RSA Are Similar for Two Fracture-Specific Implant Systems

Background: Various fracture-specific reverse shoulder arthroplasty (RSA) systems exist on the market. We set out to examine whether the type of prosthesis used and the means of fixation (cemented or non-cemented) influenced the rate of tuberosity healing or the functional outcome of the operation. Methods: This retrospective cohort multicenter study included 146 patients who underwent RSA for an acute three- or four-part proximal humerus fracture and had a minimum follow-up of one year. Six fellowship-trained surgeons at two different centers performed all operations. The implants were either Tornier Aequalis or Depuy Delta Xtend, both fracture-specific Grammont-style systems. Results: The mean age ± standard deviation (SD) was 76 ± 7 years, and 83% of patients were female. The mean ± SD follow-up time was 30 ± 31 months. The Aequalis prosthesis was used in 82 patients (56%), and the Delta Xtend in 64 patients (44%). A total of 105 RSAs (72%) were cemented. Tuberosity healing rate was similar for the two implant systems (71% Aequalis vs. 82% Delta Xtend, p = 0.15) and for the cemented or non-cemented, respectively (73% cemented vs. 83% non-cemented, p = 0.22). There was no significant difference in the motion and functional outcomes between the two implant systems in this study. Conclusions: RSA for complex PHF in the elderly has similar short-term results, regardless of the type of fracture-specific implant or the fixation technique (cemented vs. cementless).