Placement of the Stemless Humeral Component in the Total Evolutive Shoulder System (TESS)

Abstract

Humeral implant design in shoulder arthroplasty has evolved over the years. The third generation shoulder prostheses have an anatomic humeral stem that replicates the 3-dimensional parameters of the proximal humerus. The overall complication rate has decreased as a result of these changes in implant design. In contrast, the rate of periprosthetic humeral fractures has increased. To avoid stem-related complications while retaining the advantages of the third generation of shoulder implants, the stemless total evolutive shoulder system has been developed. The indications, the surgical technique, and the complications of this humeral implant in shoulder arthroplasty will be described.

Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis

“…In accordance with several other studies [25, 34], our results show significant improvement in shoulder function and pain relief across the entire investigation series. In particular, the clinical results noted here for the stemless shoulder prosthesis were comparable with those reported by other authors [19–21]. However, we did not detect a significant difference in the range of movement, DASH score, and Constant score between both types of prosthesis within the follow-up period.…”

“…Therefore, the stemless shoulder prosthesis was introduced as a new modern shoulder replacement system that was designed to reduce the potential risks associated with using a stemmed humeral implant. Today, a few types of stemless shoulder implants are available, but only a few studies have reported the clinical results of using them [19–21]. Therefore, the purpose of the study described in this paper was to evaluate the clinical and radiological midterm results of using a stemless shoulder prosthesis in comparison with the results of using a conventional stemmed shoulder prosthesis in patients with primary osteoarthritis (OA) of the shoulder.…”

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

“…Recently, the trend in shoulder arthroplasty has shifted to stemless and short stem implants [13]. Anatomic stemless prostheses have been shown to provide good functional outcomes that are comparable to those of a stemmed prosthesis, with excellent bone fixation and without radiolucent lines or loosening [14,15]. Even in the reverse configuration, studies report good results without loosening [12,16,17].…”

Radiolucency in stemless shoulder arthroplasty is associated with an imaging phenomenon

“…It is defined by implantation into the humeral metaphysis after resection of the humeral head without additional fixation in the shaft . Humeral anatomy shows broad variations in the population and the stemless designs have been thought to better reproduce the humeral anatomy because positioning constraints with respect to the humeral shaft are absent . Intraoperative complications observed with stemmed implants, including spiral fractures during reaming or stem malpositioning with subsequent head malpositioning, should be eliminated with the stemless design .…”