Utility of polymer cerclage cables in revision shoulder arthroplasty.

Abstract

Revision shoulder arthroplasty often requires humeral osteotomy for stem extraction or is complicated by periprosthetic fracture. In these situations, various modes of fixation are used, including cerclage wires, cable plates, and allograft strut augmentation. The use of metal wires and cables, however, has been associated with soft tissue irritation, sharps injuries, and accelerated wear of joint arthroplasty bearing surfaces. As an alternative to traditional metal cables, the SuperCable (Kinamed Inc, Camarillo, California) contains braided ultra-high molecular-weight polyethylene fibers surrounding a nylon core. To date, no studies have examined the use of nonmetallic cerclage cables in shoulder arthroplasty.A retrospective review was performed of 11 patients who underwent shoulder arthroplasty for which nonmetallic cerclage cables were used. Clinical and radiographic data were examined regarding patient age, procedure performed, indication for cerclage cabling, time to healing of osteotomy or fracture, and any complications associated with the use of these cerclage cables. Minimum follow-up was 1 year. Ten patients underwent reverse total shoulder arthroplasty, and 1 patient underwent revision unconstrained total shoulder arthroplasty. Mean follow-up was 20.5 months. Ten patients required humeral osteotomy for stem or cement removal. Allograft augmentation was performed in 7 patients. Mean time to healing was 3.2 months. No patients experienced loosening or migration of hardware or allograft, and no complications directly related to the use of nonmetallic cerclage cables were identified.