Early reports of stemless shoulder arthroplasty have shown promising clinical and radiological outcomes. The purpose of this study was to report on the mid-term results of an implant that utilises a ceramic humeral head.
Methods
A prospective, consecutive, multicentre study of stemless shoulder prosthesis with a minimum of four years of follow-up was conducted between August 2009 and May 2012. The adjusted Constant–Murley Score (CMS), revision rate and presence of radiolucent lines were recorded at intervals.
Results
A total of 207 patients were eligible for study inclusion; 62.8% were female and mean age was 64.8 years (range 30–86). Mean follow-up was 70.7 months (range 48–100), 73% underwent TSA and 27% hemiarthroplasty. The mean CMS improvement was 42.6 (p < 0.0001) at 48 months. Radiolucencies were present in 2.7% of humeral zones and 14% of glenoid zones at 48-month follow-up. The revision rate was 6.3% with rotator cuff failure (2.9%) the most common indication.
Conclusions
Mid-term results demonstrate that the studied stemless implant with a ceramic humeral head had clinical and radiological outcomes that are comparable to other reported studies.
LoIKLitchfieldRBGriffinS, et al.Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial. J Bone Joint Surg Am2005; 87: 2178–2185.
2.
BryantDLitchfieldRSandowM, et al.A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis. J Bone Joint Surg Am2005; 87: 1947–1956.
3.
MahfouzMNicholsonGKomistekR, et al.In vivo determination of the dynamics of normal, rotator cuff deficient, total and reverse replacement shoulders. J Bone Joint Surg Am2005; 87: 107–113.
4.
LamFBhatiaDNMostofiSB, et al.Biomechanical considerations of the normal and rotator cuff deficient shoulders and the reverse shoulder prosthesis. Curr Orthop2007; 21: 40–46.
5.
AmbacherT. Options and limits of stemless shoulder prostheses. Orthopade2013; 42: 495–500.
6.
BohsaliKIWirthMARockwoodCAJr. Complications of total shoulder arthroplasty. J Bone Joint Surg Am2006; 88: 2279–2289.
ChurchillRSAthwalGS. Stemless shoulder arthroplasty – current results and designs. Curr Rev Musculoskelet Med2016; 9: 10–16.
9.
AthwalGS. Spare the canal: stemless shoulder arthroplasty is finally here: commentary on an article by R. Sean Churchill, MD, et al: “Clinical and radiographic outcomes of the Simpliciti canal-sparing shoulder arthroplasty system; a prospective two-year multicentre study”. J Bone Joint Surg Am2016; 98: e28–e28.
10.
HawiNTauberMMessinaMJ, et al.Anatomic stemless shoulder arthroplasty and related outcomes: a systematic review. BMC Musculoskelet Disord2016; 17: 376–376.
11.
WangSZhangSZhaoY. A comparison of polyethylene wear between cobalt-chrome ball heads and alumina ball heads after total hip arthroplasty: a 10-year follow-up. J Orthop Surg2013; 8: 20–20.
12.
WroblewskiBMSineyPDDowsonD, et al.Prospective clinical and joint simulator studies of a new total hip arthroplasty using alumina ceramic heads and cross-linked polyethylene cups. J Bone Joint Surg Br1996; 78: 280–285.
13.
MuellerUBraunSSchroederS, et al.Influence of humeral head material on wear performance in anatomic shoulder joint arthroplasty. J Shoulder Elbow Surg2017; 26: 1756–1764.
14.
GreinerSBKaabMIrlenbuschU. Glenoid morphology affects the incidence of radiolucent lines around cemented pegged polyethylene glenoid components. Arch Orthop Trauma Surg2013; 133: 1331–1339.
15.
HuguetDDeClercqGRioB, et al.Results of a new stemless shoulder prosthesis: radiologic proof of maintained fixation and stability after a minimum of three years’ follow-up. J Shoulder Elbow Surg2010; 19: 847–852.
16.
HabermeyerPLichtenbergSTauberM, et al.Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg2015; 24: 1463–1472.
17.
BerthAPapG. Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis. J Orthop Traumatol2013; 14: 31–37.
18.
RazmjouHHoltbyRChristakisM, et al.Impact of prosthetic design on clinical and radiologic outcomes of total shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg2013; 22: 206–214.
19.
MaierMWLauerSKlotzMC, et al.Are there differences between stemless and conventional stemmed shoulder prostheses in the treatment of glenohumeral osteoarthritis?BMC Musculoskelet Disord2015; 16: 275–275.
20.
BellSNCoghlanJA. Short stem shoulder replacement. Int J Shoulder Surg2014; 8: 72–75.
21.
SchochCHuthJAghajevE, et al.Die metaphysär verankerte Prothese bei posttraumatischer und primärer Omarthrose. Obere Extremität2011; 6: 275–281.
22.
BrunnerUHFruthMRücklK, et al.Die schaftfreie Eclipse-Prothese – Indikation und mittelfristige Ergebnisse. Obere Extremität2012; 7: 22–28.
23.
ChurchillRSChuinardCWiaterJM, et al.Clinical and radiographic outcomes of the simpliciti canal-sparing shoulder arthroplasty system: a prospective two-year multicenter study. J Bone Joint Surg Am2016; 98: 552–560.
24.
KrukenbergAMcBirnieJBartschS, et al.Sidus stem-free shoulder system for primary osteoarthritis: short-term results of a multicenter study. J Shoulder Elbow Surg2018; 27: 1483–1490.
25.
BeckSBeckVWegnerA, et al.Long-term survivorship of stemless anatomical shoulder replacement. Int Orthop2018; 42: 1328–1330.
26.
HawiNMagoschPTauberM, et al.Nine-year outcome after anatomic stemless shoulder prosthesis: clinical and radiologic results. J Shoulder Elbow Surg2017; 26: 1609–1615.
27.
UschokSMagoschPMoeM, et al.Is the stemless humeral head replacement clinically and radiographically a secure equivalent to standard stem humeral head replacement in the long-term follow-up? A prospective randomized trial. J Shoulder Elbow Surg2016; 26: 225–232.
28.
AldingerPRRaissPRickertM, et al.Complications in shoulder arthroplasty: an analysis of 485 cases. Int Orthop2010; 34: 517–524.
29.
ElhassanBOzbaydarMMassiminiD, et al.Transfer of pectoralis major for the treatment of irreparable tears of subscapularis: does it work?J Bone Joint Surg Br2008; 90: 1059–1065.
30.
YoungAAWalchGPapeG, et al.Secondary rotator cuff dysfunction following total shoulder arthroplasty for primary glenohumeral osteoarthritis: results of a multicenter study with more than five years of follow-up. J Bone Joint Surg Am2012; 94: 685–693.
31.
KumarSSperlingJWHaidukewychGH, et al.Periprosthetic humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am2004; 86-A: 680–689.
32.
RadnayCSSetterKJChambersL, et al.Total shoulder replacement compared with humeral head replacement for the treatment of primary glenohumeral osteoarthritis: a systematic review. J Shoulder Elbow Surg2007; 16: 396–402.
33.
EdwardsTBKadakiaNRBoulahiaA, et al.A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis results of a multicentre study. J Shoulder Elbow Surg2003; 12: 207–213.
34.
BryantDLitchfieldRSandowM, et al.A comparison of pain, strength, range of motion and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis. J Bone Joint Surg Am2005; 87: 1947–1956.
35.
RispoliDMSperlingJWAthwalGS, et al.Humeral head replacement for the treatment of osteoarthritis. J Bone Joint Surg Am2006; 88: 2637–2644.
36.
LevineWNDjurasovicMGlassonHM, et al.Hemiarthroplasty for glenohumeral osteoarthritis: results correlated to degree of glenoid wear. J Shoulder Elbow Surg1997; 6: 449–454.
37.
LevineWNFischerCRNguenD, et al.Long-term follow-up of shoulder hemiarthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am2012; 94: e164–e164.
38.
BoileauPTrojaniCWalchG, et al.Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elbow Surg2001; 10: 299–308.
39.
BrunnerUKohlerS. Shoulder arthroplasty for treatment of the sequelae of proximal humerus fractures. Orthopade2007; 36: 1037–1049.
40.
RazfarNReevesJMLangohrDG, et al.Comparison of proximal humeral bones stresses between stemless, short stem, and standard stem length: a finite element analysis. J Shoulder Elbow Surg2015; 25: 1076–1083.
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