Archives of Orthopaedic and Trauma Surgery

, Volume 139, Issue 2, pp 149–154 | Cite as

Short-term results of a second generation anatomic short-stem shoulder prosthesis in primary osteoarthritis

  • Marc SchnetzkeEmail author
  • Thomas Wittmann
  • Patric Raiss
  • Gilles Walch
Orthopaedic Surgery



The aim of the study was to evaluate the short-term clinical results of anatomic total shoulder arthroplasty with a short-stem prosthesis in primary osteoarthritis.

Materials and methods

65 shoulders with a mean age of 70 years (range 47–85 years) were available for minimum follow-up of 24 months. Clinical outcome was determined by range of motion, Constant score (CS) age and sex-adjusted Constant score (CS%), and subjective shoulder value (SSV). The influence of six different factors (high bone adaptations, age > 65 years, female gender, dominant side, atrophy of the supraspinatus tendon ≥ grade 2, glenoid type B2/B3) on the clinical outcome was assessed.


At mean follow-up of 37 months (range 24–58 months), the CS improved from 36 ± 8 to 75 ± 12 (p < 0.001). The shoulder flexion (100° ± 21° to 159° ± 19°) as well as the external rotation (3° ± 11° to 43° ± 18°) improved significantly (p < 0.001). Three complications were noted (transient neuropraxia of the radial nerve, subjective instability, hematoma with superficial wound infection) leading to one revision surgery (wound debridement). No stem loosening was observed. High bone adaptation was present in 19 out of 65 shoulders (29%). The clinical outcome was not influenced by high bone adaptations (p ≥ 0.095). Age > 65 years (n = 44) and female gender (n = 38) were associated with worse clinical outcome (p ≤ 0.043).


In the short term, the clinical results of this anatomical short-stem shoulder prosthesis are encouraging. A low prevalence of high bone adaptations was found without any influence on the clinical outcome and stem loosening was not observed.


Total shoulder arthroplasty Short stem Primary osteoarthritis Anatomical Shoulder replacement Stem loosening 



There is no funding source.

Compliance with ethical standards

Conflict of interest

Gilles Walch received royalties from Tornier/Wright, and Patric Raiss is consultant from Tornier/Wright, which is related to the subject of this work. No company had any input into the study design, protocol, testing, data analysis, or manuscript preparation. The other authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

Ethical approval

Ethical committee approval was obtained: Lyon/France: No. 2016-20.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Aldinger PR, Raiss P, Rickert M, Loew M (2010) Complications in shoulder arthroplasty: an analysis of 485 cases. Int Orthop 34(4):517–524. CrossRefGoogle Scholar
  2. 2.
    Bohsali KI, Wirth MA, Rockwood CA Jr (2006) Complications of total shoulder arthroplasty. J Bone Jt Surg Am 88(10):2279–2292. Google Scholar
  3. 3.
    Casagrande DJ, Parks DL, Torngren T, Schrumpf MA, Harmsen SM, Norris TR, Kelly JD 2nd (2016) Radiographic evaluation of short-stem press-fit total shoulder arthroplasty: short-term follow-up. J Shoulder Elbow Surg 25(7):1163–1169. CrossRefGoogle Scholar
  4. 4.
    Casagrande DJ, Parks DL, Torngren T, Schrumpf MA, Harmsen SM, Norris TR, Kelly JD 2nd (2016) Radiographic evaluation of short-stem press-fit total shoulder arthroplasty: short-term follow-up. J Shoulder Elbow Surg. Google Scholar
  5. 5.
    Churchill RS (2014) Stemless shoulder arthroplasty: current status. J Shoulder Elbow Surg 23(9):1409–1414. CrossRefGoogle Scholar
  6. 6.
    Denard PJ, Noyes MP, Walker JB, Shishani Y, Gobezie R, Romeo AA, Lederman E (2018) Radiographic changes differ between two different short press-fit humeral stem designs in total shoulder arthroplasty. J Shoulder Elbow Surg 27(2):217–223. CrossRefGoogle Scholar
  7. 7.
    Deshmukh AV, Koris M, Zurakowski D, Thornhill TS (2005) Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg 14(5):471–479. CrossRefGoogle Scholar
  8. 8.
    Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 304:78–83Google Scholar
  9. 9.
    Habermeyer P, Lichtenberg S, Tauber M, Magosch P (2015) Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg 24(9):1463–1472. CrossRefGoogle Scholar
  10. 10.
    Khan A, Bunker TD, Kitson JB (2009) Clinical and radiological follow-up of the Aequalis third-generation cemented total shoulder replacement: a minimum ten-year study. J Bone Jt Surg Br 91(12):1594–1600. CrossRefGoogle Scholar
  11. 11.
    Landis JR, Koch GG (1977) An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics 33(2):363–374CrossRefGoogle Scholar
  12. 12.
    Loew M (2013) Short stem shoulder prosthesis: concept and first results. Orthopade 42(7):501–506. CrossRefGoogle Scholar
  13. 13.
    Morwood MP, Johnston PS, Garrigues GE (2017) Proximal ingrowth coating decreases risk of loosening following uncemented shoulder arthroplasty using mini-stem humeral components and lesser tuberosity osteotomy. J Shoulder Elbow Surg 26(7):1246–1252. CrossRefGoogle Scholar
  14. 14.
    Raiss P, Edwards TB, Deutsch A, Shah A, Bruckner T, Loew M, Boileau P, Walch G (2014) Radiographic changes around humeral components in shoulder arthroplasty. J Bone Jt Surg Am 96(7):e54. CrossRefGoogle Scholar
  15. 15.
    Raiss P, Schmitt M, Bruckner T, Kasten P, Pape G, Loew M, Zeifang F (2012) Results of cemented total shoulder replacement with a minimum follow-up of ten years. J Bone Jt Surg Am 94(23):e1711–e1710. CrossRefGoogle Scholar
  16. 16.
    Romeo AA, Thorsness RJ, Sumner SA, Gobezie R, Lederman ES, Denard PJ (2017) Short-term clinical outcome of an anatomic short-stem humeral component in total shoulder arthroplasty. J Shoulder Elbow Surg. Google Scholar
  17. 17.
    Sanchez-Sotelo J, Wright TW, O’Driscoll SW, Cofield RH, Rowland CM (2001) Radiographic assessment of uncemented humeral components in total shoulder arthroplasty. J Arthroplasty 16(2):180–187. CrossRefGoogle Scholar
  18. 18.
    Schnetzke M, Coda S, Raiss P, Walch G, Loew M (2016) Radiologic bone adaptations on a cementless short-stem shoulder prosthesis. J Shoulder Elbow Surg 25(4):650–657. CrossRefGoogle Scholar
  19. 19.
    Schnetzke M, Coda S, Walch G, Loew M (2015) Clinical and radiological results of a cementless short stem shoulder prosthesis at minimum follow-up of two years. Int Orthop 39(7):1351–1357. CrossRefGoogle Scholar
  20. 20.
    Schnetzke M, Preis A, Coda S, Raiss P, Loew M (2017) Anatomical and reverse shoulder replacement with a convertible, uncemented short-stem shoulder prosthesis: first clinical and radiological results. Arch Orthop Trauma Surg 137(5):679–684. CrossRefGoogle Scholar
  21. 21.
    Schnetzke M, Rick S, Raiss P, Walch G, Loew M (2018) Mid-term results of anatomical total shoulder arthroplasty for primary osteoarthritis using a short-stemmed cementless humeral component. Bone Jt J 100(5):603–609. CrossRefGoogle Scholar
  22. 22.
    Szerlip BW, Morris BJ, Laughlin MS, Kilian CM, Edwards TB (2018) Clinical and radiographic outcomes after total shoulder arthroplasty with an anatomic press-fit short stem. J Shoulder Elbow Surg 27(1):10–16. CrossRefGoogle Scholar
  23. 23.
    Verborgt O, El-Abiad R, Gazielly DF (2007) Long-term results of uncemented humeral components in shoulder arthroplasty. J Shoulder Elbow Surg 16(3 Suppl):S13–S18. CrossRefGoogle Scholar
  24. 24.
    Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 14(6):756–760CrossRefGoogle Scholar
  25. 25.
    Werner BC, Dines JS, Dines DM (2016) Platform systems in shoulder arthroplasty. Curr Rev Musculoskelet Med 9(1):49–53. CrossRefGoogle Scholar
  26. 26.
    Werthel JD, Lonjon G, Jo S, Cofield R, Sperling JW, Elhassan BT (2017) Long-term outcomes of cemented versus cementless humeral components in arthroplasty of the shoulder: a propensity score-matched analysis. Bone Jt J 99(5):666–673. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.BG Trauma Center Ludwigshafen at the University of HeidelbergLudwigshafenGermany
  2. 2.OCM Klinik MünchenMunichGermany
  3. 3.Centre Orthopédique SantyLyonFrance

Personalised recommendations