Aims. The purpose of this study was to compare clinical results, long-term survival, and complication rates of stemless shoulder prosthesis with stemmed anatomical shoulder prostheses for treatment of osteoarthritis and to analyze radiological bone changes around the implants during follow-up. Methods. A total of 161 patients treated with either a stemmed or a stemless shoulder arthroplasty for primary osteoarthritis of the shoulder were evaluated with a mean follow-up of 118 months (102 to 158). The Constant score (CS), the Disabilities of the Arm, Shoulder and Hand (DASH) score, and active range of motion (ROM) were recorded. Radiological analysis for bone adaptations was performed by plain radiographs. A Kaplan-Meier survivorship analysis was calculated and complications were noted. Results. The ROM (p < 0.001), CS (p < 0.001), and DASH score (p < 0.001) showed significant improvements after shoulder arthroplasty for both implants. There were no differences between the groups treated with stemmed or stemless shoulder prosthesis with respect to the mean CS (79.2 (35 to 118) vs 74.4 (31 to 99); p = 0.519) and DASH scores (11.4 (8 to 29) vs 13.2 (7 to 23); p = 0.210). The ten-year unadjusted cumulative survival rate was 95.3% for the stemmed anatomical shoulder prosthesis and 91.5% for the stemless shoulder prosthesis and did not differ between the treatment groups (p = 0.251). The radiological evaluation of the humeral components in both groups did not show loosening of the humeral implant. The main reason for revision for each type of arthroplasties were complications related to the glenoid. Conclusion. The use of anatomical stemless shoulder prosthesis yielded good and reliable results and did not differ from anatomical stemmed shoulder prosthesis over a mean period of ten years. The differences in periprosthetic humeral bone adaptations between both implants have no clinical impact during the follow-up. Cite this article: Bone Joint J 2021;103-B(7):1292–1300

Aims

The aims of this study were to investigate any possible relationship between a preoperative sensitivity to pain and the degree of pain at rest and on exertion with postoperative function in patients who underwent stemless total shoulder arthroplasty (TSA).

Introduction. The new era of shoulder arthroplasty is moving away from long stemmed, cemented humeral components to cementless, stemless and metaphyseal fixed implants and to humeral resurfacing. The early clinical results and functional outcome of stemless shoulder arthroplasty is presented. Methods. A retrospective single-surgeon series of stemless shoulder prostheses implanted from 2011 to 2013 at our institution was evaluated. Perioperative complications, Theatre time and length of hospital stay (LOS) were recorded. Postoperative radiographic and clinical evaluation including measurement of joint mobility, the Oxford Shoulder Score (OSS), and Disabilities of the Arm, Shoulder and Hand (DASH) score by independent evaluators were made. Results. A total of 23 stemless shoulder arthroplasty were implanted in 22 patients. Mean age was 57.8 years. Mean follow up was 22 months (8–45). Symptomatic primary gleno-humeral osteoarthritis was the main indication for implantation (83%). None of the patients experienced periprosthetic fractures, glenoid notching, and implant loosening/migration. Mean OSS (44 ± 6.0) and mean DASH score (11 ± 6.5). Mean operative time was (88 ± 16.0 min) and mean length of hospital stay (1.1 ± 0.82 day). Active shoulder motion improved by (mean): 30° (95% CI 10–45) external rotation, 67° (95% CI 30- 100) forward elevation and 54° (95% CI 35- 90) Abduction. Conclusion. The implantation of stemless shoulder prosthesis in our institution offered good clinical results manifested by improved range of motion and favourable patient reported outcome measures. Although long term follow up is warranted, early results appear promising in young patients with symptomatic gleno-humeral osteoarthritis

Over the last decade stemless shoulder arthroplasty has become increasingly popular. However, stability of metaphyseal loading humeral components remains a concern. This study aimed to assess the stability of the Affinis stemless humeral component using Radiostereometric analysis (RSA). Patients underwent total shoulder arthroplasty via a standardised technique with a press-fit stemless humeral component and a cemented pegged glenoid. Tantalum beads were inserted into the humerus at the time of operation. RSA of the relaxed shoulder was completed at weeks 1, 6, 13, 26, 52 and 104 post-operatively. Stressed RSA with 12 newtons of abduction force was completed from week 13 onwards. ABRSA 5.0 software (Downing Imaging Limited, Aberdeen) was used to calculate humeral component migration and induced movement. 15 patients were recruited. Precision was: 0.041, 0.034, 0.086 and 0.101 mm for Superior, Medial, Posterior and Total Point Motion (TPM) respectively. The mean TPM over 2 years was 0.24 (0.30) mm, (Mean (Standard deviation)). The mean rate of migration per 3 month time period decreased from 0.45 (0.31) to 0.02 (0.01) mm over 2 years. Mean inducible movement TPM peaked at 26 weeks at 0.1 (0.08) mm, which reduced to 0.07 (0.06) mm by 104 weeks when only 3 patients had measurable inducible motion. There was no clear trend in direction of induced movement. There were no adverse events or revisions required. We conclude migration of the humeral component was low with little inducible movement in the majority of patients implying initial and 2 year stability of the stemless humeral component

Stemless shoulder arthroplasty implants for the proximal humerus provide cementless metaphyseal prosthetic fixation. A near-perfect anatomic restoration of the proximal humeral articular surface is possible with this canal-sparing design—avoiding the risks associated with humeral stems and preserving bone for later revision. When compared with proximal humeral resurfacing, stemless arthroplasty avoids the potential technical errors that may lead to oversized implants, abnormal shift of the glenohumeral joint center of rotation, and excessive strain on the native rotator cuff. While canal-sparing stemless implants represent a new concept in shoulder arthroplasty without mid- and long-term results, the failures associated with resurfacing humeral arthroplasty have been documented in the literature. Unlike a stemless component, use of a resurfacing technique (and hence preservation of the humeral head) makes glenoid prosthetic implantation challenging and often impossible

Aims

Stemless humeral implants have been developed to overcome stem-related complications in total shoulder arthroplasty (TSA). However, stemless implant designs may hypothetically result in less stable initial fixation, potentially affecting long-term survival. The aim of this study is to investigate early fixation and migration patterns of the stemless humeral component of the Simpliciti Shoulder System and to evaluate clinical outcomes.

Aims

The use and variety of stemless humeral components in anatomical total shoulder arthroplasty (TSA) have proliferated since their advent in 2004. Early outcomes are reassuring but independent mid-term results are scarce. This independent study reports a consecutive series of 143 Eclipse stemless shoulder prostheses with a minimum five-year (5 to 10) follow-up.