Eclipse stemless shoulder prosthesis vs. Univers II shoulder prosthesis: a multicenter, prospective randomized controlled trial

Romeo, Anthony A.; Erickson, Brandon J.; Costouros, John G.; Long, N. M.; Klassen, Jeffrey F.; Araghi, Arash; Brown, J. G.; Setter, Kevin J.; Port, Joshua; Tyndall, William; Verma, Nikhil N.; Sears, Benjamin W.; Brandon, Thomas A.; Smith, Mark; McFadden, Earl; Patterson, Paul; Stein, Jason; Cohen, Brian S.; Abboud, Joseph A.

doi:10.1016/j.jse.2020.07.004

Cited by 20 publications

(28 citation statements)

References 21 publications

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“…16 Regarding the glenoid implant, there was a radiolucent line at the last follow-up in 14.3% of the stemless TSA and 26.7% in the stemmed TSAs, although the difference did not reach statistical significance. 16 Romeo et al 19 did not observe radiolucent lines on follow-up imaging at any time point; however, they noted that this may be due to the relatively short followup period in comparison with studies that described this in stemless designs. 16,35 radiolucency of .2 mm in two shoulders in the stemmed cohort and none in the stemless cohort, but no signs of loosening in either cohort, and concluded that stemless TSA demonstrated noninferiority regarding radiographic outcomes.…”

Section: Radiographic Assessmentsmentioning

confidence: 88%

“…16 Stemmed implant designs included the Univers II (Arthrex), 16,19 Aequalis, 17 and Comprehensive Mini (Zimmer Biomet). 18 Stemless designs included the Eclipse (Arthrex), 16,19 Aequalis, 17 and Comprehensive Nano (Zimmer Biomet). 18 In all four studies, surgical exposure was achieved through a deltopectoral approach.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…18 In all four studies, surgical exposure was achieved through a deltopectoral approach. [16][17][18][19] Subscapularis tenotomy with tendon-to-tendon reattachment was used exclusively in one study, 16 while a combination of subscapularis tenotomy and lesser tuberosity osteotomy was done based on surgeon preference in the remaining three studies. [17][18][19] The use of cementing and fixation was done according to manufacturer's specifications.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Outcomes Between Stemmed and Stemless Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials

et al. 2022

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Introduction: Both stemmed and stemless designs for total shoulder arthroplasty (TSA) have demonstrated efficacious outcomes for the surgical treatment of primary glenohumeral joint osteoarthritis. The purpose of this systematic review and meta-analysis was to compare the clinical outcomes of stemmed versus stemless TSA in randomized controlled trials. We hypothesized that there would be no differences in Constant Score (CS), range of motion, or adverse events, such as periprosthetic fracture and/or revision surgery. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a systematic review of the literature was done using MEDLINE, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Registry of Controlled Trials, Embase, and Web of Science databases. Outcomes of interest included CS, range of motion, and adverse events (periprosthetic fracture and revision). Summary effect estimates of the mean difference between stemmed and stemless TSA for each outcome were estimated in random effects models. Results: The search yielded 301 articles with 4 appropriate for qualitative analysis, including the results of 229 stemmed and 358 stemless TSAs. No significant difference was observed in postoperative CS (P = 0.36), forward flexion (P = 0.93), abduction (P = 0.30), or external rotation (P = 0.34) between stemmed and stemless TSA. No significant difference was observed in change in CS (P = 0.27), forward flexion (P = 0.25), or external rotation (P = 0.74). A change in abduction was significantly different between stemmed and stemless TSA (standardized mean difference = 20.64; 95% confidence interval, 21.20 to 20.08) in favor of stemmed TSA (P = 0.02), attributed to preoperative differences. No significant difference was observed in periprosthetic fractures (P = 0.07) or revision (P = 0.90).

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Section: Radiographic Assessmentsmentioning

confidence: 88%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Outcomes Between Stemmed and Stemless Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials

et al. 2022

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“…Although our results correspond to previous short-term follow-up studies, clinical outcomes should be interpreted with caution. [9][10][11][12][13][14][15][16] Stemless shoulder systems have been developed in order to reduce stem-related problems, to preserve more bone stock and to make revision surgery less complex. In our study, we reported one revision and no periprosthetic fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the noninferiority of stemless implants compared with stemmed implants in the short-to mid-term follow-up has been demonstrated in several high-quality studies. [9][10][11][12][13][14][15][16] However, only two studies have been published with a minimum of tenyear follow-up. Magosch et al 17 demonstrated a survival of 96.5% in 75 shoulders.…”

Section: Introductionmentioning

confidence: 99%

Early fixation of the humeral component in stemless total shoulder arthroplasty

Brinke

Hesseling

Eygendaal

et al. 2022

The Bone & Joint Journal

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Aims Stemless humeral implants have been developed to overcome stem-related complications in total shoulder arthroplasty (TSA). However, stemless implant designs may hypothetically result in less stable initial fixation, potentially affecting long-term survival. The aim of this study is to investigate early fixation and migration patterns of the stemless humeral component of the Simpliciti Shoulder System and to evaluate clinical outcomes. Methods In this prospective cohort study, radiostereometric analysis (RSA) radiographs were obtained in 24 patients at one day, six weeks, six months, one year, and two years postoperatively. Migration was calculated using model-based RSA. Clinical outcomes were evaluated using the visual analogue scale (VAS), the Oxford Shoulder Score (OSS), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Results At two years, median translation along the x-, y-, and z-axis was -0.12 mm (interquartile range (IQR) -0.18 to 0.02), -0.17 mm (IQR -0.27 to -0.09), and 0.09 mm (IQR 0.02 to 0.31). Median rotation around the x-, y-, and z-axis was 0.12° (IQR -0.50 to 0.57), -0.98° (IQR -1.83 to 1.23), and 0.09° (IQR -0.76 to 0.30). Overall, 20 prostheses stabilized within 12 months postoperatively. Four prostheses showed continuous migration between 12 and 24 months. At two-year follow-up, with the exception of one revised prosthesis, all clinical scores improved significantly (median VAS difference at rest: -3.0 (IQR -1.5 to -6.0); OSS 22.0 (IQR 15.0 to 25.0); CMS 29.5 (IQR 15.0 to 35.75); and DASH -30.0 (IQR -20.6 to -41.67) (all p < 0.001)) with the exception of one revised prosthesis. Conclusion In conclusion, we found that 20 out of 24 implants stabilized within 12 months postoperatively. The significance of continuous migration in four implants is unclear and future research on the predictive value of early migration for future loosening in TSA is required. Clinical results revealed a clinically relevant improvement. Cite this article: Bone Joint J 2022;104-B(1):76–82.

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Stemmed VS stemless total shoulder arthroplasty: a systematic review and meta-analysis

Schönweger,

Oldrini,

Feltri

et al. 2024

Arch Orthop Trauma Surg

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Eclipse stemless shoulder prosthesis vs. Univers II shoulder prosthesis: a multicenter, prospective randomized controlled trial

Cited by 20 publications

References 21 publications

Outcomes Between Stemmed and Stemless Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Outcomes Between Stemmed and Stemless Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Early fixation of the humeral component in stemless total shoulder arthroplasty

Stemmed VS stemless total shoulder arthroplasty: a systematic review and meta-analysis

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