Geometrical analysis of stemless shoulder arthroplasty: a radiological study of seventy TESS total shoulder prostheses

Kadum, Bakir; Hassany, Hamid; Wadsten, Mats; Sayed-Noor, Arkan S.; Sjödén, Göran O.

doi:10.1007/s00264-015-2935-z

Cited by 38 publications

(27 citation statements)

References 32 publications

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“…We used this best-ﬁt circle to measure the deviation of the center of the prosthesis to the premorbid CoR. Previous studies demonstrated that a malpositioning of 3 to 4 mm can affect the clinical outcome[ 5 , 12 , 29 - 31 ]. According to Alolabi et al[ 12 ] and Kadum et al[ 31 ], we defined a deviation of 3 mm as clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

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

Engelhardt

Manzke

Breil-Wirth

et al. 2017

WJO

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AIMTo evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS system.METHODSTwenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation (CoR) was assessed and compared to the CoR of the prosthesis by using the MediCAD® software. Additionally, the pre- and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus. Radiological changes, such as radiolucencies, were also assessed. Clinical outcome was assessed with the Constant and DASH score.RESULTSBoth, the Constant and DASH scores improved significantly from 11% to 75% and from 70 to 30 points, P < 0.01 respectively. There were no significant differences regarding age, etiology, cemented or metal-backed glenoids, etc. (P > 0.05). The pre- and postoperative humeral offset, the lateral glenohumeral offset, the height of the CoR, the acromiohumeral distance as well as neck-shaft angle showed no significant changes (P > 0.05). The mean deviation of the CoR of the prosthesis from the anatomic center was 1.0 ± 2.8 mm. Three cases showed a medial deviation of more than 3 mm. These deviations of 5.1, 5.7 and 7.6 mm and were caused by an inaccurate humeral neck cut. These 3 patients showed a relatively poor outcome scoring.CONCLUSIONTESS arthroplasty allows an anatomical joint reconstruction with a very good outcome. Outliers described in this study sensitize the surgeon for an accurate humeral neck cut.

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Section: Discussionmentioning

confidence: 99%

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

Engelhardt

Manzke

Breil-Wirth

et al. 2017

WJO

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“…Several studies have investigated the ability of different prosthetic designs to restore humeral head anatomy using several radiographic imaging modalities. 7,12,14,19 However, only one of these studies directly examined the relationship of stem length and postoperative humeral head anatomic restoration. 19 The purpose of this study was to examine the impact of humeral component stem length on the ability to restore the native humeral head anatomy after TSA.…”

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confidence: 99%

Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

Cox

Sholder

Stoll

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Humeral stem designs for total shoulder arthroplasty have varied over the years, with a recent trend toward shorter stems. The purpose of this study was to examine the impact of humeral component stem length on the ability to restore the native humeral head anatomy. Methods: We performed a retrospective review including patients who underwent total shoulder arthroplasty for primary osteoarthritis between 2007 and 2017 with complete operative reports and adequate radiographs. Surgical data including stem design were collected. Preoperative and postoperative radiographic measurements of the center of rotation (COR), humeral head height (HH), and neck-shaft angle were performed. Restoration of the native humeral anatomy was deemed ''acceptable'' based on postoperative differences in the COR 3 mm, HH 5 mm, and neck-shaft angle > 130. Deviations between preoperative and postoperative measurements were compared across stem types. All available 2-year stemless implant radiographs were also analyzed. Results: In total, 261 patients were included, with 31 stemless, 43 short-stem, and 187 standard-stem implants. There was no significant difference in COR restoration in the x-axis direction (P ¼ .060) or y-axis direction (P ¼ .579). There was no significant difference in restoration of acceptable HH by stem type (P ¼ .339). Stemless arthroplasty implants were more likely to be placed in varus (22.6%) compared with short-stem (7.0%) and standard-stem (3.7%) designs (P < .001). Conclusion: Restoration of humeral anatomic parameters occurred significantly less with stemless implants than with short-and standard-stem implants. The stem of a shoulder arthroplasty implant aids surgeons in accurately restoring patient-specific anatomy.

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“…Even in the reverse configuration, studies report good results without loosening [12,16,17]. Anatomic stemless prostheses help to restore the pre-operative proximal humerus anatomy [18]. If the need for revision arises, stemless implants facilitate the surgical procedure as the bone stock is preserved.…”

Section: Discussionmentioning

confidence: 98%

Stemless shoulder prosthesis for treatment of proximal humeral malunion does not require tuberosity osteotomy

Ballas

Teissier

Teissier³

2016

International Orthopaedics (SICOT)

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Geometrical analysis of stemless shoulder arthroplasty: a radiological study of seventy TESS total shoulder prostheses

Cited by 38 publications

References 32 publications

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

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

Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

Stemless shoulder prosthesis for treatment of proximal humeral malunion does not require tuberosity osteotomy

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