Radiographic assessment of uncemented humeral components in total shoulder arthroplasty

Seventy-two total shoulder arthroplasties performed using Neer II press-fit humeral components and followed for an average of 4.1 years (range, 2-7.8 years) were analyzed radiographically. A humeral component was considered radiographically at risk for clinical loosening when a radiolucent fine greater than or equal to2 mm in width was present in greater than or equal to3 zones or tilt or subsidence was identified on sequential radiographs by 2 of 3 or 3 of 3 independent observers. Forty components (55.6%) were judged to be at risk. There were no identifiable characteristics associated with the development of an at-risk humeral component except longer average follow-up of the at-risk group (4.7 years vs 3.3 years, P=.001). Humeral components at risk had a higher rate of endosteal erosion (P = .04) and greater number of zones with sclerosis. Radiographic changes around Neer II uncemented humeral components are common. Data from this study can he used as 1 benchmark to compare with alternate methods of humeral component fixation.