Reverse total shoulder arthroplasty (RTSA) treats rotator cuff–deficient shoulders. Stemless designs preserve humeral bone stock and reduce operative time. Interest in stemless RTSA has grown recently.
Methods
A literature search was performed in Scopus through February 21, 2026. Extracted data included publication metrics. Bibliometric visualization and knowledge mapping (co-authorship, co-citation, topic trends, thematic maps) were completed using the bibliometrix and biblioshiny packages. Outcomes included scientific output, institutional productivity, citation metrics, influential authors and journals, most cited documents, keyword patterns, and author productivity per Lotka's law.
Results
A total of 129 articles on stemless RTSA were identified, accumulating 2003 citations. Publications rose steadily, with sustained growth observed after 2021 (P < .05). Citation counts showed a parallel rise (P < .05). The United States was the most productive country (26.86% of total publications), the University of Western Ontario the leading institution, and Abboud J.A. and Athwal G.S. the most prolific authors. The Journal of Shoulder and Elbow Surgery was the most cited journal and demonstrated the highest h-index (h-index = 9).
Conclusion
Evidence for stemless RTSA is expanding and demonstrates international engagement but remains limited primarily to short- to mid-term outcomes. Larger, multicenter studies with longer follow-up are needed.
BaulotESirveauxFBoileauP. Grammont’s idea: the story of paul grammont’s functional surgery concept and the development of the reverse principle. Clin Orthop Relat Res2011; 469: 2425–2431.
2.
BoileauPWatkinsonDJHatzidakisAM, et al.Grammont reverse prosthesis: design, rationale, and biomechanics. J Shoulder Elbow Surg2005; 14: 147S–161S.
3.
HattaTMashikoRKawakamiJ, et al.Evolution of stemless reverse shoulder arthroplasty: current indications, outcomes, and future prospects. J Clin Med2024; 13: 3813.
4.
BroströmLAWallenstenROlssonE, et al.The kessel prosthesis in total shoulder arthroplasty. A five-year experience. Clin Orthop Relat Res1992; 277: 155–160.
5.
DoyleTRDowneySHurleyET, et al.Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up. JSES Rev Rep Tech2024; 4: 1–7.
6.
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.
7.
LazarusMDCoxRMMurthiAM, et al.Stemless prosthesis for total shoulder arthroplasty. J Am Acad Orthop Surg2017; 25: e291–e300.
8.
SchnetzkeMCodaSRaissP, et al.Radiologic bone adaptations on a cementless short-stem shoulder prosthesis. J Shoulder Elbow Surg2016; 25: 650–657.
9.
AntoniMBouchePAObertL, et al.Stemless RSA shows good short-term radiological stability and clinical outcomes in elderly patients. Semin Arthroplasty JSES2024; 34: 762–769.
10.
TracySTWernerBCSteinbeckJ, et al.Revision to reverse total shoulder arthroplasty: do short stem and stemless implants reduce the operative burden compared to convertible stems?Semin Arthroplasty JSES2021; 31: 248–254.
11.
SakekFHaightHTuphéP, et al.Assessment of intraoperative bleeding in reverse shoulder arthroplasty - with or without a stem. Orthop Traumatol Surg Res OTSR2022; 108: 103245.
12.
CascajaresMAlcaydeASalmerón-ManzanoE, et al.The bibliometric literature on scopus and WoS: the medicine and environmental sciences categories as case of study. Int J Environ Res Public Health2021; 18: 5851.
13.
KowRYLowCLAbbasAA, et al.Bibliometric analysis of Malaysian orthopaedic journal using scopus database. Malays Orthop J2024; 18: 1–9.
14.
MathaRMukherjeeSPanigrahiRR, et al.A bibliometric analysis of industry 5.0 and healthcare supply chain research: emerging opportunities and future challenges. Supply Chain Anal2025; 10: 100125.
15.
WerthelJ-DWalchGVegehanE, et al.Lateralization in reverse shoulder arthroplasty: a descriptive analysis of different implants in current practice. Int Orthop2019; 43: 2349–2360.
16.
BallasRBéguinL. Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening. J Shoulder Elbow Surg2013; 22: e1–e6.
LevyONarvaniAHousN, et al.Reverse shoulder arthroplasty with a cementless short metaphyseal humeral implant without a stem: clinical and radiologic outcomes in prospective 2- to 7-year follow-up study. J Shoulder Elbow Surg2016; 25: 1362–1370.
19.
KeenerJDChalmersPNYamaguchiK. The humeral implant in shoulder arthroplasty. J Am Acad Orthop Surg2017; 25: 427–438.
20.
HawiNTauberMMessinaMJ, et al.Anatomic stemless shoulder arthroplasty and related outcomes: a systematic review. BMC Musculoskelet Disord2016; 17: 376.
21.
TeissierPTeissierJKouyoumdjianP, et al.The TESS reverse shoulder arthroplasty without a stem in the treatment of cuff-deficient shoulder conditions: clinical and radiographic results. J Shoulder Elbow Surg2015; 24: 45–51.
22.
GoettiPDenardPJCollinP, et al.Biomechanics of anatomic and reverse shoulder arthroplasty. EFORT Open Rev2021; 6: 918–931.
23.
KadumBMafiNNorbergS, et al.Results of the total evolutive shoulder system (TESS): a single-centre study of 56 consecutive patients. Arch Orthop Trauma Surg2011; 131: 1623–1629.
24.
PauzenbergerLDomejMAHeubererPR, et al.The effect of intravenous tranexamic acid on blood loss and early post-operative pain in total shoulder arthroplasty. Bone Jt J2017; 99-B: 1073–1079.
25.
AwadGBoutrosMAsmarC, et al.Stemless vs. stemmed reverse total shoulder arthroplasty as primary treatment in the elderly: A meta-analysis. Shoulder Elb2025. https://doi.org/10.1177/17585732251388447
26.
BaumgartenKM. Stemless and stemmed total shoulder arthroplasty: a comparison of short-term clinical and radiographic outcomes. Semin Arthroplasty JSES2023; 33: 67–78.
27.
LiuEYKordDYeeNJ, et al.Stemless reverse total shoulder arthroplasty: a systematic review of short- and mid-term results. Shoulder Elb2021; 13: 482–491.
28.
LeonidouAViraniSBuckleC, et al.Reverse shoulder arthroplasty with a cementless short metaphyseal humeral prosthesis without a stem: survivorship, early to mid-term clinical and radiological outcomes in a prospective study from an independent centre. Eur J Orthop Surg Traumatol Orthop Traumatol2020; 30: 89–96.
29.
DaherMFaresMYBoufadelP, et al.Osteoporosis in the setting of shoulder arthroplasty: a narrative review. Geriatr Orthop Surg Rehabil2023; 14: 21514593231182527.
30.
RitterDDenardPJRaissP, et al.Preoperative 3-dimensional computed tomography bone density measures provide objective bone quality classifications for stemless anatomic total shoulder arthroplasty. J Shoulder Elbow Surg2024; 33: 1503–1511.
31.
GregoryJMSiahaanJUrvoyM. Preoperative metaphyseal cancellous bone density is associated with intraoperative conversion to stemmed total shoulder arthroplasty. JSES Rev Rep Tech2023; 3: 285–288.
32.
CunninghamDEHabisAAUddinFZN, et al.Stemless reverse shoulder arthroplasty neck shaft angle influences humeral component time-zero fixation and survivorship: a cadaveric biomechanical assessment. JSES Int2024; 8: 880–887.
33.
FavrePSeebeckJThistlethwaitePAE, et al.In vitro initial stability of a stemless humeral implant. Clin Biomech2016; 32: 113–117.
34.
PlathJESaiczekNMayrE, et al.Long-term clinical and radiological outcomes of a stemless reverse shoulder implant that is fallen out of favor - stemless nano-reverse shoulder arthroplasty. BMC Musculoskelet Disord2026; 27: 59.
35.
LiXSuJHanJ, et al.Coronavirus disease-2019 and orthopedics: a bibliometric analysis of the literature. Medicine (Baltimore)2024; 15: e37714.
36.
HeckmannNDMayfieldCKRichardsonMK, et al.An updated estimate of total hip and total knee arthroplasty inpatient case volume during the 2020 COVID-19 pandemic in the United States. Arthroplasty Today2024; 26: 101336.
37.
Avant-Garde Health and Codman Shoulder Society Value Based Care Group, KhanAZBestMJ, et al. Impact of the COVID-19 pandemic on shoulder arthroplasty: surgical trends and postoperative care pathway analysis. J Shoulder Elbow Surg2022; 31: 2457–2464.
HuangT-YLiLMengP. Journal internationalization of non-English-speaking countries: indicator framework design and influencing factor analysis. J Informetr2025; 19: 101671.
40.
Di BitettiMSFerrerasJA. Publish (in English) or perish: the effect on citation rate of using languages other than English in scientific publications. Ambio2017; 46: 121–127.
41.
WillemsJIPHoffmannJSiereveltIN, et al.Results of stemless shoulder arthroplasty: a systematic review and meta-analysis. EFORT Open Rev2021; 6: 35–49.
42.
A’CourtJJChatindiaraIFisherR, et al.Does the stemless reverse arthroplasty compare to a conventional stemmed implant? Clinical and radiographic evaluation at 2 years’ minimum follow-up. J Shoulder Elbow Surg2024; 33: 1938–1945.
43.
ShinY-SLeeW-SWonJ-S. Comparison of stemless and conventional stemmed shoulder arthroplasties in shoulder arthropathy: a meta-analysis. Medicine (Baltimore)2021; 100: e23989.
