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Stemless reverse total shoulder arthroplasty: a systematic review of contemporary literature

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Abstract

Purpose

Reverse shoulder prostheses are increasingly used for treatment of rotator cuff tear arthropathy and other degenerative shoulder diseases. In recent years, aiming for bone stock preservation has led to the design of metaphyseal humeral components without a stem. The aims of this study were to evaluate the complication and reintervention rates, as well as the clinical and radiographic outcomes in patients who underwent reverse shoulder arthroplasty (RSA) with stemless implants.

Methods

A systematic review of the literature was completed until May 2020 using PubMed, EMBASE, CINAHL and Cochrane databases, according to PRISMA guidelines.

Results

The literature search revealed 2942 studies, of which 13 were included in this review, with a total of 517 patients and a mean follow-up between 6.4 and 101.6 months. The total complication rate was 6.5%, while 3.3% were humeral associated complications. Finally, the rate of shoulders that underwent a reintervention was 6.7%, with 1.4% relating to a humeral component reason. Stemless RSA led to substantial improvements in patient reported outcome measures and range of motion across all studies. Scapular notching was reported in 15.2%, and lucencies around humeral component were reported in 0.8% of shoulders.

Conclusion

Stemless RSA resulted in low complication and reintervention rates at the mid-term follow-up. The reported clinical and radiological outcomes showed that these prostheses have at least equivalent outcomes with their stemmed counterparts. Further studies are required to investigate the long-term longevity and performance of the stemless humeral implants.

Level of evidence

Level IV; Systematic Review

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Acknowledgements

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Authors and Affiliations

  1. Surgery Department, Hôpital Maisonneuve-Rosemont, Montreal University, 5415 Boulevard de l’Assomption, Montréal, Québec, H1T 2M4, Canada

    L. Kostretzis & M. Shahin

  2. 2nd Department of Orthopaedic Surgery, G.Gennimatas Hospital, Aristotle University of Thessaloniki, Ethnikis Aminis 41, 546 35, Thessaloniki, Greece

    P. Konstantinou, I. Pinto, K. Ditsios & P. Papadopoulos

Authors
  1. L. Kostretzis
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  2. P. Konstantinou
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  3. I. Pinto
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Contributions

Lazaros Kostretzis helped in the development of idea, data collection and writing of manuscript. Panagiotis Konstantinou contributed to data collection and writing of manuscript. Iosafat Pinto and Maged Shahin were involved in writing of manuscript. Konstantinos Ditsios and Pericles Papadopoulos contributed to supervision of project and editing of manuscript.

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Correspondence to L. Kostretzis.

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Appendix

Appendix

See Tables 7, 8, 9, 10.

Table 7 Search terms a. Pubmed database, b. EMBASE database, c. CINAHL database d.Cochrane database
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Table 8 Modified Coleman methodology score
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Table 9 Studies’ characteristics
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Table 10 Indication for surgery
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Kostretzis, L., Konstantinou, P., Pinto, I. et al. Stemless reverse total shoulder arthroplasty: a systematic review of contemporary literature. Musculoskelet Surg 105, 209–224 (2021). https://doi.org/10.1007/s12306-021-00710-1

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