Stemless reverse total shoulder arthroplasty: a systematic review of contemporary literature

Kostretzis, Lazaros; Konstantinou, Panagiotis; Pinto, Iosafat; Shahin, Maged; Δίτσιος, Κωνσταντίνος; Papadopoulos, Pericles

doi:10.1007/s12306-021-00710-1

Cited by 14 publications

(9 citation statements)

References 34 publications

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“…Liu et al 48 pooled 324 stemless RSA patients from seven studies with early and mid-term results (mean follow-up 44 months) demonstrating notable improvements in ROM and functional scores; no evidence of humeral loosening; and complication and revision rates of 12% and 5%, respectively. Kostretzis et al 49 echoed these findings in their systematic review of 517 patients from 13 studies with mean follow-up ranging between six and 102 months, citing complication and revision rates both of 7%. Of those revisions, only 1.4% were related to humeral implant issues.…”

Section: Clinical Outcomes Based On Implant Designmentioning

confidence: 94%

“…Estimated rates of complications requiring revision after stemless RSA range between 3.8% and 5.8%. 7,9,35,49 In the largest systematic review to date, this revision rate equated to a survival rate of 96% at an average of 42 months. 49 Despite the uniqueness of humeral fixation in stemless RSA and the theoretical concern for loosening, many studies have shown limited humeral-associated causes of revision.…”

Section: Complicationsmentioning

confidence: 99%

“…7,9,35,49 In the largest systematic review to date, this revision rate equated to a survival rate of 96% at an average of 42 months. 49 Despite the uniqueness of humeral fixation in stemless RSA and the theoretical concern for loosening, many studies have shown limited humeral-associated causes of revision. In their systematic review of 324 cases, Liu et al 48 found that only three of 17 revisions were because of early humeral implant displacement (1%).…”

Section: Complicationsmentioning

confidence: 99%

“…Pooled analyses have described complication rates between 6.5% and 13.7%. 7,44,48,49 The TESS implant, which remains the most studied design, has an overall complication rate ranging from 1% to 13%. 36,37,45 Variation in complication rates reported can be because of variation in surgical indications.…”

Section: Complicationsmentioning

confidence: 99%

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Stemless Reverse Shoulder Arthroplasty

Luthringer,

Horneff,

Abboud

2023

J Am Acad Orthop Surg

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Since the Food and Drug Administration (FDA) approval nearly two decades ago, the indications for and utilization of reverse shoulder arthroplasty (RSA) have expanded considerably. Stemless RSA designs have been used in Europe since 2005, but have only recently been introduced in domestic Investigational Device Exemption trials. Potential advantages of stemless RSA are similar to those of stemless anatomic total shoulder arthroplasty, which may include fewer shaft-related complications, avoidance of stress shielding, bone preservation, and easier revision surgery. European data support similar outcomes between certain stemless RSA prostheses compared with that of stemmed RSA implants at early and mid-term follow-up. However, long-term outcomes remain to be seen and differences exist between the stemless RSA designs used in Europe and those being studied in domestic clinical trials. An understanding of the potential advantages and disadvantages of stemless RSA, differences between existing designs, and reported clinical outcomes is prudent for the safe and meaningful implementation of this new technology in the United States.

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Section: Clinical Outcomes Based On Implant Designmentioning

confidence: 94%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

Stemless Reverse Shoulder Arthroplasty

Luthringer,

Horneff,

Abboud

2023

J Am Acad Orthop Surg

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“…However, similar to the short stem component, the risk of malalignment is relatively higher than in the conventional stem [59]. Although recent studies have presented encouraging outcomes with stemless design, it is a concern that studies have only reported short-to mid-term outcomes [60][61][62][63]. Furthermore, complications such as tray failure and periprosthetic fracture of the lateral cortex due to impaction of the implant have been reported (Fig.…”

Section: Humeral Componentmentioning

confidence: 99%

Implant selection for successful reverse total shoulder arthroplasty

Jeong

Won

2022

Clin Shoulder Elbow

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Reverse total shoulder arthroplasty (RTSA) emerged as a new concept of arthroplasty that does not restore normal anatomy but does restore function. It enables the function of the torn rotator cuff to be performed by the deltoid and shows encouraging clinical outcomes. Since its introduction, various modifications have been designed to improve the outcome of the RTSA. From the original cemented baseplate with peg or keel, a cementless baseplate was designed that could be fixed with central and peripheral screws. In addition, a modular-type glenoid component enabled easier revision options. For the humeral component, the initial design was an inlay type of long stem with cemented fixation. However, loss of bone stock from the cemented stem hindered revision surgery. Therefore, a cementless design was introduced with a firm metaphyseal fixation. Furthermore, to prevent complications such as scapular notching, the concept of lateralization emerged. Lateralization helped to maintain normal shoulder contour and better rotator cuff function for improved external/internal rotation power, but excessive lateralization yielded problems such as subacromial notching. Therefore, for patients with pseudoparalysis or with risk of subacromial notching, a medial eccentric tray option can be used for distalization and reduced lateralization of the center of rotation. In summary, it is important that surgeons understand the characteristics of each implant in the various options for RTSA. Furthermore, through preoperative evaluation of patients, surgeons can choose the implant option that will lead to the best outcomes after RTSA.

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Finite element analysis part 2 of 2: Glenohumeral bone stress distribution depends on implant configuration for anatomic and reverse stemless shoulder implants

Housset,

Srikumaran,

Daudet

et al. 2024

J. exp. orthop.

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PurposeOur purpose was to quantify stresses in the bone surrounding stemless implants in various configurations.MethodsA detailed finite element model of the glenohumeral joint was used to simulate abduction kinematics before and after arthroplasty and to measure bone stresses around the implants. Two digital patients were simulated: one healthy and one with supraspinatus muscle impairment (deficiency). Two anatomic total shoulder arthroplasty (TSA) configurations were placed in a 135° cutting plane. Two reverse shoulder arthroplasty (RSA) configurations with cutting angles of 135° and 145° were simulated with asymmetrical and symmetrical polyethylene cups, respectively, to obtain humeral neck‐shaft angles of 145°.ResultsCompared with preoperative models, TSA preserved and RSA restored abduction kinematics. The bone mechanical stresses were located mainly around the central stud of the TSA and were more peripheral to the RSA humeral components. The RSA configuration with the 145° cutting angle and symmetrical cup generated the lowest maximal bone stress and bone volume involvement. Stresses in the scapular cortical bone were highest in the supraspinatus fossa for TSA and the crest of the acromion for RSA.ConclusionEarly stability and glenohumeral bone stress change with implant configuration and should not be extrapolated from anatomic clinical data to reverse configurations.Level of EvidenceDiagnostic tests or criteria; Level IV.

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Stemless reverse total shoulder arthroplasty: a systematic review of contemporary literature

Cited by 14 publications

References 34 publications

Stemless Reverse Shoulder Arthroplasty

Stemless Reverse Shoulder Arthroplasty

Implant selection for successful reverse total shoulder arthroplasty

Finite element analysis part 2 of 2: Glenohumeral bone stress distribution depends on implant configuration for anatomic and reverse stemless shoulder implants

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