Small implants nella protesica di spalla

  • Carlo StoppaniEmail author
  • Pietro S. Randelli


In over a century of history, shoulder prosthetics has seen numerous developments in terms of both design and surgical indications: from the first monobloc hemiarthroplasty proposed by Neer, many innovations have occurred, which led to the development of complete modular prostheses. Nowadays, anatomic shoulder arthroplasties are able to adapt to patient-specific anatomical characteristics. Reverse shoulder arthroplasty, which revolutionised articular biomechanics, has provided a possible solution for the treatment of patients with rotator cuff failure. The attempt to reduce complications related to traditional implants and the desire to guarantee greater bone stock preservation have pushed the research towards a progressive reduction in humeral stem length until its complete elimination. At the same time, researchers have studied and developed surface implants that reduce pain with minimal changes in the original anatomy. Humeral head resurfacing consists in a metal cap that covers the articular portion of the proximal humeral epiphysis without any substantial osteotomy of the humeral head. Despite their recent introduction, the results offered by the so-called small implants appear to be very promising and it is reasonable to expect their significant diffusion in the future.

Small implants in shoulder arthroplasty


Conflitto di interesse

L‘autore Carlo Stoppani dichiara di non aver alcun conflitto di interesse. L’autore Pietro Simone Randelli dichiara di aver eseguito consulenze per le aziende: Johnson & Johnson, Medacta, Microport, Smith and Nephew, Zimmer-Biomet nel corso dell’anno 2018.

Consenso informato e conformità agli standard etici

Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

Human and Animal Rights

L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.


  1. 1.
    Bankes MJ, Emery RJ (1995) Pioneers of shoulder replacement: themistocles Gluck and Jules Emile Péan. J Shoulder Elb Surg 4:259–262 CrossRefGoogle Scholar
  2. 2.
    Neer CS (1955) Articular replacement for the humeral head. J Bone Jt Surg, Am 37-A:215–228 CrossRefGoogle Scholar
  3. 3.
    Neer CS (1974) Replacement arthroplasty for glenohumeral osteoarthritis. J Bone Jt Surg, Am 56:1–13 CrossRefGoogle Scholar
  4. 4.
    Deore VT, Griffiths E, Monga P (2018) Shoulder arthroplasty. Past, present and future. J Arthrosc Jt Surg 5:3–8 CrossRefGoogle Scholar
  5. 5.
    Flatow EL, Harrison AK (2011) A history of reverse total shoulder arthroplasty. Clin Orthop Relat Res 469:2432–2439 CrossRefGoogle Scholar
  6. 6.
    Brolin TJ, Thakar OV, Abboud JA (2018) Outcomes after shoulder replacement surgery in the young patient. Clin Sports Med 37:593–607 CrossRefGoogle Scholar
  7. 7.
    Levy O, Tsvieli O, Merchant J et al. (2015) Surface replacement arthroplasty for glenohumeral arthropathy in patients aged younger than fifty years: results after a minimum ten-year follow-up. J Shoulder Elb Surg 24:1049–1060 CrossRefGoogle Scholar
  8. 8.
    Alizadehkhaiyat O, Kyriakos A, Singer MS, Frostick SP (2013) Outcome of Copeland shoulder resurfacing arthroplasty with a 4-year mean follow-up. J Shoulder Elb Surg 22:1352–1358 CrossRefGoogle Scholar
  9. 9.
    Verstraelen FU, Horta LA, Schotanus MG et al. (2018) Clinical and radiological results 7 years after Copeland shoulder resurfacing arthroplasty in patients with primary glenohumeral osteoarthritis: an independent multicentre retrospective study. Eur J Orthop Surg Traumatol 28:15–22 CrossRefGoogle Scholar
  10. 10.
    Geervliet PC, van den Bekerom MP, Spruyt P et al. (2017) Outcome and revision rate of uncemented glenohumeral resurfacing (CAP) after 5–8 years. Arch Orthop Trauma Surg 137:771–778 CrossRefGoogle Scholar
  11. 11.
    Rasmussen JV, Olsen BS, Sorensen AK et al. (2015) Resurfacing hemiarthroplasty compared to stemmed hemiarthroplasty for glenohumeral osteoarthritis: a randomised clinical trial. Int Orthop 39:263–269 CrossRefGoogle Scholar
  12. 12.
    Rasmussen JV, Polk A, Sorensen AK et al. (2014) Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder: 837 operations reported to the Danish Shoulder Arthroplasty Registry. J Bone Jt 96-B:519–525 Google Scholar
  13. 13.
    Al-Hadithy N, Domos P, Sewell MD et al. (2012) Cementless surface replacement arthroplasty of the shoulder for osteoarthritis: results of fifty Mark III Copeland prosthesis from an independent center with four-year mean follow-up. J Shoulder Elb Surg 21:1776–1781 CrossRefGoogle Scholar
  14. 14.
    Athwal GS, Sperling JW, Rispoli DM, Cofield RH (2009) Periprosthetic humeral fractures during shoulder arthroplasty. J Bone Jt Surg, Am 91:594–603 CrossRefGoogle Scholar
  15. 15.
    Singh JA, Sperling J, Schleck C et al. (2012) Periprosthetic fractures associated with primary total shoulder arthroplasty and primary humeral head replacement: a thirty-three-year study. J Bone Jt Surg, Am 94:1777–1785 CrossRefGoogle Scholar
  16. 16.
    Bohsali KI, Wirth MA, Rockwood CA (2006) Complications of total shoulder arthroplasty. J Bone Jt Surg 88:2279 Google Scholar
  17. 17.
    Merolla G, Wagner E, Sperling JW et al. (2018) Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants. J Shoulder Elb Surg 27:75–81 CrossRefGoogle Scholar
  18. 18.
    Eichinger JK, Galvin JW (2015) Management of complications after total shoulder arthroplasty. Curr Rev Musculoskelet Med 8:83–91 CrossRefGoogle Scholar
  19. 19.
    Huguet D, DeClercq G, Rio B et al. (2010) 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 19:847–852 CrossRefGoogle Scholar
  20. 20.
    Brolin TJ, Cox RM, Abboud JA, Namdari S (2017) Stemless shoulder arthroplasty: review of early clinical and radiographic results. J Bone Jt Surg Rev 5:1–9 Google Scholar
  21. 21.
    Berth A, Pap G (2013) Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis: a comparison of the functional outcome after a minimum of two years follow-up. J Orthop Traumatol 14:31–37 Google Scholar
  22. 22.
    Ballas R, Béguin L (2013) Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening. J Shoulder Elb Surg 22(9):1–6 CrossRefGoogle Scholar
  23. 23.
    Kadum B, Mukka S, Englund E et al. (2014) Clinical and radiological outcome of the Total Evolutive Shoulder System (TESS®) reverse shoulder arthroplasty: a prospective comparative non-randomised study. Int Orthop 38:1001–1006 CrossRefGoogle Scholar
  24. 24.
    Teissier P, Teissier J, Kouyoumdjian P, Asencio G (2015) The TESS reverse shoulder arthroplasty without a stem in the treatment of cuff-deficient shoulder conditions: clinical and radiographic results. J Shoulder Elb Surg 24:45–51 CrossRefGoogle Scholar
  25. 25.
    Moroder P, Ernstbrunner L, Zweiger C et al. (2016) Short to mid-term results of stemless reverse shoulder arthroplasty in a selected patient population compared to a matched control group with stem. Int Orthop 40:2115–2120 CrossRefGoogle Scholar

Copyright information

© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2019

Authors and Affiliations

  1. 1.Università degli Studi di MilanoMilanoItalia
  2. 2.Laboratorio di Biomeccanica Applicata, Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoMilanoItalia
  3. 3.1a Clinica OrtopedicaASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, MilanoMilanoItalia

Personalised recommendations