Stemless reverse total shoulder arthroplasty: a systematic review

Ajibade, David A.; Yin, Clark; Hussein, Hamid S; Wiater, Brett P.; Martusiewicz, Alexander; Wiater, J. Michael

doi:10.1016/j.jse.2021.12.017

Cited by 15 publications

(11 citation statements)

References 63 publications

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“…The TESS implant has also demonstrated early success, with short-term evidence showing notable improvement in patient satisfaction, functional outcomes, and postoperative ROM. 36,37,44,45 Early scapular notching was slightly higher in the TESS implant, ranging from 13 to 30% of cases; the incidence of humeral radiolucent lines was not reported in these studies. 36,37,45 More noteworthy was early glenoid loosening noted in two of the studies (seven of 72 patients in total) and one study showing early humeral loosening in a patient who underwent stemless reverse arthroplasty as a revision procedure.…”

Section: Clinical Outcomes Based On Implant Designmentioning

confidence: 66%

“…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%

“…51 Not surprisingly, it is also the most frequently reported complication in stemless RSA. 44,48,49 Many of these dislocations occur in stemless RSAs performed for fracture or other indications with humeral bone loss that can result in loss of proper deltoid tension. 8,44,45 Because of limitations in humeral implant height positioning and the need for adequate fixation in the metaphyseal bone, instability may be more likely to occur.…”

Section: Complicationsmentioning

confidence: 99%

“…8,44,45 Because of limitations in humeral implant height positioning and the need for adequate fixation in the metaphyseal bone, instability may be more likely to occur. 44 Another complication of concern is periprosthetic fractures. As mentioned before, impaction of the humeral implant into metaphyseal bone with thinner cortices can result in intraoperative fractures.…”

Section: Complicationsmentioning

confidence: 99%

“…Similarly, Kostretzis et al 49 reviewed 517 cases with only three reports of humeral aseptic loosening causing revision (0.7%). Finally, Ajibade et al 44 found only one of 437 cases requiring revision for a loose humeral implant, accounting for 0.2% of cases. Revision rates in the studies reviewed in that analysis ranged from 0% to 25% overall.…”

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: 66%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

See 3 more Smart Citations

Stemless Reverse Shoulder Arthroplasty

Luthringer,

Horneff,

Abboud

2023

J Am Acad Orthop Surg

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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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