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Current Reviews in Musculoskeletal Medicine

Erschienen in:

01.03.2016 | Shoulder Arthroplasty (G Athwal, Section Editor)

Stemless shoulder arthroplasty—current results and designs

verfasst von: R. Sean Churchill, George S. Athwal

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 1/2016

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Abstract

Stemless shoulder arthroplasty was originally introduced in 2004 by a single manufacturer. Now, over a decade later, numerous designs are available outside the USA, but as yet, only one implant has been cleared by the Food and Drug Administration (FDA) and is available for use within the USA. Often referred to as “canal sparing,” these implants are designed for metaphyseal fixation to minimize humeral bone removal, avoid intraoperative and postoperative humeral fracture complications, and to decrease morbidity associated with revision operations. Recently, the second generation of stemless arthroplasty, a convertible implant allowing use in either anatomic or reverse arthroplasty configuration, was released for use outside the USA. This paper will review the available designs, reported results, and raise potential concerns for this emerging technology.

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Sahota S, Sperling JW, Cofield RH. Humeral windows and longitudinal splits for component removal in revision shoulder arthroplasty. J Shoulder Elb Surg. 2014;23(10):1485–91. doi:10.1016/j.jse.2014.02.004. An excellent report reviewing humeral window and longitudinal revision techniques for stemmed implants. 23 of 26 windows healed and 17 of 19 longitudinal splits healed. There were no cases of malunion or clinical loosening at last follow up.CrossRef

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Van Thiel GS, Halloran JP, Twigg S, Romeo AA, Nicholson GP. The vertical humeral osteotomy for stem removal in revision shoulder arthroplasty: results and technique. J Shoulder Elb Surg. 2011;20(8):1248–54. doi:10.1016/j.jse.2010.12.013.CrossRef

24.••

Huguet D, DeClercq G, Rio B, Teissier J, Zipoli B, TESS Group. Results of a new stemless shoulder prosthesis: radiologic proof of maintained fixation and stability after a minimum of three years’ follow-up. J Shoulder Elb Surg. 2010;19(6):847–52. doi:10.1016/j.jse.2009.12.009. The original paper regarding stemless shoulder arthroplasty results. Sixty-three patients involved, 44 received a hemiarthroplasty and 19 a total shoulder arthroplasty. This paper has three year minimum results with good outcome measures including Constant score and range of motion. 11.1% revision rate at final follow up.CrossRef

25.••

Berth A, Pap G. Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis. J Orthop Traumatol. 2013;14(1):31–7. doi:10.1007/s10195-012-0216-9. The only prospective, randomized study comparing stemmed and stemless shoulder arthroplasty. This is a two year minimum follow up study showing no difference in clinical or radiographic results between the two groups. Significantly shorter operative time and blood loss was noted in the stemless group.PubMedCentralCrossRefPubMed

26.••

Churchill RS, Chuinard C, Wiater JM, Friedman R, Freehill M, Jacobson S, et al. Clinical and Radiographic Outcomes of the Simpliciti Canal Sparing Shoulder Arthroplasty System: A prospective 2 year multi-center study. J Bone Joint Surg., Accepted, publication date pending. JBJS-D-15-00181R4. The largest and most complete of the stemless arthroplasty reports. 149 patients with complete data at 2 weeks, 3 months, 1 year and 2 years follow up. This is the IDE study that obtained FDA clearance for the Simpliciti stemless system, the only stemless system available in the United States.

27.••

Habermeyer P, Lichtenberg S, Tauber M, Magosch P. Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elb Surg. 2015;24(9):1463–72. doi:10.1016/j.jse.2015.02.023. The only midterm report on stemless shoulder arthroplasty. This paper reviews the 5 year clinical and radiographic results of the Eclipse implant. Radiographic bone loss in the metaphyseal region was noted in over 46% of patients at final follow up.CrossRef

28.•

Ballas R, Beguin L. Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening. J Shoulder Elb Surg. 2013;22(9):e1–6. doi:10.1016/j.jse.2012.12.005. The first report available on a reverse stemless shoulder arthroplasty system. This paper reviews the minimum three year follow up of the TESS reverse implant. Revision rate was 7% at latest follow up.CrossRef

29.•

Teissier P, Teissier J, Kouyoumdjian P, Asencio G. The TESS reverse shoulder arthroplasty without a stem in the treatment of cuff-deficient shoulder conditions: clinical and radiographic results. J Shoulder Elb Surg. 2015;24(1):45–51. doi:10.1016/j.jse.2014.04.005. Two year minimum results on 91 patients with the TESS reverse implant. Excellent outcomes noted with Constant score and range of motion. Revision rate 1% at final follow up.CrossRef

30.

Churchill RS. Stemless shoulder arthroplasty: current status. J Shoulder Elb Surg. 2014;23(9):1409–14. doi:10.1016/j.jse.2014.05.005.CrossRef

Titel: Stemless shoulder arthroplasty—current results and designs
verfasst von: R. Sean Churchill
George S. Athwal
Publikationsdatum: 01.03.2016
Verlag: Springer US
Erschienen in: Current Reviews in Musculoskeletal Medicine / Ausgabe 1/2016
Elektronische ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-016-9320-4

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