Stemless shoulder arthroplasty is a fairly new concept. Clinical and radiological follow-up is essential to prove implant safety and concept. This prospective single-centre study was performed to evaluate the influence of radiological changes on clinical mid-term outcome following stemless humeral head replacement with hollow screw fixation.
Short- and mid-term radiological and clinical evaluations were performed in 73 consecutive shoulders treated mainly for idiopathic and posttraumatic osteoarthritis with stemless humeral head arthroplasty including 40 hemi- (HSA) and 33 total shoulder arthroplasties (TSA). Operating times of stemless implantations were compared to 110 stemmed anatomical shoulder prostheses. Appearances of humeral radiolucencies or radiological signs of osteolysis or stress shielding were assessed on standardized radiographs. Patients’ clinical outcome was evaluated using the Constant score and patients’ satisfaction was documented.
Radiological changes, detected in 37.0%, did not affect clinical outcome. Constant scores significantly improved from baseline to short and mid-term follow-up (p < 0.001). The majority of patients (96.2%) were satisfied with the procedure. No loosening of the humeral head component was detected during a mean follow-up of 58 months. Operating times were significantly shorter with stemless compared to stemmed implants (p < 0.001).
Clinical mid-term outcome after stemless humeral head replacement was not affected by radiological changes.
The institutional review board (St. Vincent Hospital Vienna; 201212_EK01; date of issue: 11.12.2012) approved the study. The trial was registered at ClinicalTrials.gov (NCT02754024). Retrospective registration.
Sajadi KR, Kwon YW, Zuckerman JD. Revision shoulder arthroplasty: an analysis of indications and outcomes. J Shoulder Elb Surg. 2010;19(2):308–13. CrossRef
Chin PY, Sperling JW, Cofield RH, Schleck C. Complications of total shoulder arthroplasty: are they fewer or different? J Shoulder Elb Surg. 2006;15(1):19–22. CrossRef
Farng E, Zingmond D, Krenek L, Soohoo NF. Factors predicting complication rates after primary shoulder arthroplasty. J Shoulder Elb Surg. 2011;20(4):557–63. CrossRef
Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;(214):160-164.
Yian EH, Ramappa AJ, Arneberg O, Gerber C. The constant score in normal shoulders. J Shoulder Elb Surg. 2005;14(2):128–33. CrossRef
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. CrossRef
Sperling JW, Cofield RH, Rowland CM. Minimum fifteen-year follow-up of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged fifty years or younger. J Shoulder Elb Surg. 2004;13(6):604–13. CrossRef
Churchill RS, Chuinard C, Wiater JM, Friedman R, Freehill M, Jacobson S, Spencer E Jr, Holloway GB, Wittstein J, Lassiter T, et al. Clinical and radiographic outcomes of the Simpliciti Canal-sparing shoulder arthroplasty system: a prospective two-year multicenter study. J Bone Joint Surg Am. 2016;98(7):552–60. CrossRefPubMed
Huguet D, DeClercq G, Rio B, Teissier J, Zipoli B, Group T. 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. CrossRef
Magosch P, Habermeyer P, Bachmaier S, Metcalfe N. Biomechanics of metaphyseal fixed humeral head replacement. Obere Extremität. 2012;7(1):11–6. CrossRef
Nagels J, Stokdijk M, Rozing PM. Stress shielding and bone resorption in shoulder arthroplasty. J Shoulder Elb Surg. 2003;12(1):35–9. CrossRef
Gonzalez JF, Alami GB, Baque F, Walch G, Boileau P. Complications of unconstrained shoulder prostheses. J Shoulder Elb Surg. 2011;20(4):666–82. CrossRef
Sperling JW, Hawkins RJ, Walch G, Mahoney AP, Zuckerman JD. Complications in total shoulder arthroplasty. Instr Course Lect. 2013;62:135–41. PubMed
- Radiological changes do not influence clinical mid-term outcome in stemless humeral head replacements with hollow screw fixation: a prospective radiological and clinical evaluation
Philipp R. Heuberer
- BioMed Central
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