“…Nineteen studies with full-length texts were identified. Finally, 8 articles [3, 10–16] that met the inclusion criteria were included in this meta-analysis after eliminating 3 studies [9, 20, 21] that did not have complete data. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…To reduce the above-mentioned potential risks associated with the humeral stem, a new generation of stemless total shoulder prostheses, such as the Total Evolutive Shoulder System (TESS; Biomet Inc. Warsaw, US), was introduced in 2004 [7]. Subsequently, almost all published studies reported that stemless total shoulder arthroplasty (slTSA) had promising radiological and clinical outcomes in short- to midterm follow-ups [8, 9].…”
BackgroundTo systematically compare the short- to midterm effectiveness of stemless prostheses to that of stemmed prostheses for patients who underwent total shoulder arthroplasty (TSA) and to provide a guideline for clinical decision-making.MethodsPubMed, the Cochrane Library, and Web of Science were searched with the given search terms until July 2019 to identify published articles evaluating the clinical outcomes for stemless prostheses compared with stemmed prostheses for patients who underwent TSA. Data extraction and the quality assessment of the included studies were independently performed by two authors. Stata software 14.0 was used to analyze and synthesize the data.ResultsTwo randomized controlled trials and six case-controlled studies with a total of 347 shoulders were included in this meta-analysis. The results of this meta-analysis showed that there were no significant differences between the stemless and stemmed prostheses in terms of the Constant score, pain score, strength, activities of daily living, postoperative range of motion (ROM), and postoperative maximum active ROM.ConclusionsThis is the first meta-analysis reporting the clinical results of stemless TSA in the short- to midterm follow-up period. Both types of shoulder prostheses were similar in achieving satisfactory clinical outcomes.
“…Nineteen studies with full-length texts were identified. Finally, 8 articles [3, 10–16] that met the inclusion criteria were included in this meta-analysis after eliminating 3 studies [9, 20, 21] that did not have complete data. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…To reduce the above-mentioned potential risks associated with the humeral stem, a new generation of stemless total shoulder prostheses, such as the Total Evolutive Shoulder System (TESS; Biomet Inc. Warsaw, US), was introduced in 2004 [7]. Subsequently, almost all published studies reported that stemless total shoulder arthroplasty (slTSA) had promising radiological and clinical outcomes in short- to midterm follow-ups [8, 9].…”
BackgroundTo systematically compare the short- to midterm effectiveness of stemless prostheses to that of stemmed prostheses for patients who underwent total shoulder arthroplasty (TSA) and to provide a guideline for clinical decision-making.MethodsPubMed, the Cochrane Library, and Web of Science were searched with the given search terms until July 2019 to identify published articles evaluating the clinical outcomes for stemless prostheses compared with stemmed prostheses for patients who underwent TSA. Data extraction and the quality assessment of the included studies were independently performed by two authors. Stata software 14.0 was used to analyze and synthesize the data.ResultsTwo randomized controlled trials and six case-controlled studies with a total of 347 shoulders were included in this meta-analysis. The results of this meta-analysis showed that there were no significant differences between the stemless and stemmed prostheses in terms of the Constant score, pain score, strength, activities of daily living, postoperative range of motion (ROM), and postoperative maximum active ROM.ConclusionsThis is the first meta-analysis reporting the clinical results of stemless TSA in the short- to midterm follow-up period. Both types of shoulder prostheses were similar in achieving satisfactory clinical outcomes.
“…Von Engelhardt et al 7 were able to restore the humeral COR in 81.0% of patients (17 of 21) by use of stemless implants in their series. Most recently, Pinto et al 19 compared the postoperative radiographic parameters of HH, humeral head diameter, humeral head centering, humeral head medial offset, LHO, and humeral neck angle of 58 stemless implants vs. 21 short-stem implants. The only parameter that was significantly different between the 2 implant designs was the head-neck angle, where the shortstem implants had a 3 decrease postoperatively.…”
Section: Discussionmentioning
confidence: 99%
“…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.…”
mentioning
confidence: 99%
“…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. We hypothesized that shoulder arthroplasty designs that use a humeral stem would better restore the native humeral head anatomy vs. stemless designs owing to the ability of the stem to act as a guide for proper implant positioning.…”
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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