Anatomic stemless shoulder arthroplasty and related outcomes: a systematic review

Abstract

BackgroundThe latest generation of shoulder arthroplasty includes canal-sparing respectively stemless designs that have been developed to allow restoration of the glenohumeral center of rotation independently from the shaft, and to avoid stem-related complications. The stemless prosthesis design has also recently been introduced for use in reverse arthroplasty systems.MethodsWe systematically reviewed the literature for studies of currently available canal-sparing respectively stemless shoulder arthroplasty systems. From the identified series, we recorded the indications, outcome measures, and humeral-sided complications.ResultsWe identified 11 studies of canal-sparing respectively stemless anatomic shoulder arthroplasty implants, published between 2010 and 2016. These studies included 929 cases, and had a mean follow-up of 26 months (range, 6 to 72 months). The rates of humeral component-related complications ranged between 0 and 7.9 %. The studies reported only a few isolated cases of complications of the humeral component. Some arthroplasty systems are associated with radiological changes, but without any clinical relevance.ConclusionsAll of the published studies of canal-sparing respectively stemless shoulder arthroplasty reported promising clinical and radiological outcomes in short to midterm follow-up. Long-term studies are needed to demonstrate the long-term value of these kind of implants.

Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty

“…Regarding these data, the TESS system allows a reliable restoration of the individual joint geometry. This might explain the relatively good clinical outcome of the TESS prosthesis described in our series as well as in previous studies with follow-up times ranging from 6 to 45 mo[ 26 - 28 , 32 - 34 ].…”

Total shoulder arthroplasty with nonspherical humeral head and inlay glenoid replacement: clinical results comparing concentric and nonconcentric glenoid stages in primary shoulder arthritis

“…The study showed better forward elevation in TSA compared with HA, whereas ER was similar. These results are comparable with stemless TSA reported by Hawi et al 19 in a systematic review of 11 studies and 929 patients with a mean follow-up of 26 months. Our range of motion results compare favorably with stemmed, stemless, and onlay resurfacing procedures—a benefit that is of particular interest to our relatively young patient population (Fig.…”

“…TSA has shown to be effective in reducing pain and improving function in numerous studies;5, 19, 23, 35, 41 however, there is a paucity in the literature comparing TSA outcomes for concentric and eccentric glenoids. To the best of our knowledge, no glenoid stage–specific investigations have been reported using stemless or onlay resurfacing implants.…”

Patient reported outcome after stemmed versus stemless total shoulder arthroplasty for glenohumeral osteoarthritis: a patient-blinded randomized clinical trial

“…Few outcome studies on stemless TSA are available. A recent review of 11 observational studies (published 2010-2016), incorporating a total of 929 patients, reported comparable short-and midterm functional outcomes between stemmed and stemless shoulder prosthesis [1]. Otherwise, there are few well-conducted and adequately powered clinical studies.…”