Advertisement

Stemless Shoulder Arthroplasty in Treating Severe Deformity

  • Bandar Assiry
  • Mitch Armstrong
  • Ryan T. Bicknell
Chapter

Abstract

Shoulder arthroplasty has undergone rapid evolution with significant advancements in design, materials, indications, and technique. Stemless shoulder arthroplasty offers many potential advantages including greater versatility in matching native anatomy, bone preservation, and less difficult revision surgery. Stemless implants also provide the theoretical advantage of decreased surgical times and less blood loss. These advantages may offer particular benefits in the setting of severe deformity. The currently available short- to midterm results are promising, but more research is needed to determine long-term survivability of the implant. Stemless reverse arthroplasty is also available, and the limited reported outcomes appear similar to the stemmed reverse implants. However, there may be a higher failure rate, and the specific indications and risks for failure have not been identified.

Keywords

Shoulder Arthroplasty Stemless Humerus 

References

  1. 1.
    Churchill RS. Stemless shoulder arthroplasty: current status. J Shoulder Elb Surg. 2014;23(9):1409–14.CrossRefGoogle Scholar
  2. 2.
    Collin P, Matsukawa T, Boileau P, Brunner U, Walch G. Is the humeral stem useful in anatomic total shoulder arthroplasty? Int Orthop (SICOT). 2017;41(5):1035–9.CrossRefGoogle Scholar
  3. 3.
    Bohsali KI, Wirth MA, Rockwood CA. Complications of total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88(10):2279–92.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Gonzalez J-F, Alami GB, Baque F, Walch G, Boileau P. Complications of unconstrained shoulder prostheses. J Shoulder Elb Surg. 2011;20(4):666–82.CrossRefGoogle Scholar
  5. 5.
    Churchill RS, Athwal GS. Stemless shoulder arthroplasty-current results and designs. Curr Rev Musculoskelet Med. 2016;9(1):10–6.CrossRefGoogle Scholar
  6. 6.
    Athwal GS, Sperling JW, Rispoli DM, Cofield RH. Periprosthetic humeral fractures during shoulder arthroplasty. J Bone Joint Surg Am. 2009;91(3):594–603.CrossRefGoogle Scholar
  7. 7.
    Boyd AD, Thornhill TS, Barnes CL. Fractures adjacent to humeral prostheses. J Bone Joint Surg Am. 1992;74(10):1498–504.CrossRefGoogle Scholar
  8. 8.
    Worland RL, Kim DY, Arredondo J. Periprosthetic humeral fractures: management and classification. J Shoulder Elb Surg. 1999;8(6):590–4.CrossRefGoogle Scholar
  9. 9.
    Huguet D, Declercq G, Rio B, Teissier J, Zipoli B, TESS Group. 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. 2010;19(6):847–52.Google Scholar
  10. 10.
    Petriccioli D, Bertone C, Marchi G. Stemless shoulder arthroplasty: a literature review. Joints. 2015;3(1):38–41.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Athwal GS. 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 multicenter study”. J Bone Joint Surg Am. 2016;98(7):e28.CrossRefGoogle Scholar
  12. 12.
    Beck S, Beck V, Wegner A, Dudda M, Patsalis T, Jäger M. Long-term survivorship of stemless anatomical shoulder replacement. Int Orthop (SICOT). 2018.Google Scholar
  13. 13.
    Hawi N, Magosch P, Tauber M, Lichtenberg S, Habermeyer P. Nine-year outcome after anatomic stemless shoulder prosthesis: clinical and radiologic results. J Shoulder Elb Surg. 2017;26(9):1609–15.CrossRefGoogle Scholar
  14. 14.
    Bell SN, Coghlan JA. Short stem shoulder replacement. Int J Shoulder Surg. 2014;8(3):72–5.CrossRefGoogle Scholar
  15. 15.
    Ballas R, Teissier P, Teissier J. Stemless shoulder prosthesis for treatment of proximal humeral malunion does not require tuberosity osteotomy. Int Orthop (SICOT). 2016;40(7):1473–9.CrossRefGoogle Scholar
  16. 16.
    Maier MW, Lauer S, Klotz MC, Bülhoff M, Spranz D, Zeifang F. Are there differences between stemless and conventional stemmed shoulder prostheses in the treatment of glenohumeral osteoarthritis? BMC Musculoskelet Disord. 2015;16(1):275.CrossRefGoogle Scholar
  17. 17.
    Cruickshank DW, Bicknell RT. Stemless shoulder replacement: a new concept for shoulder arthritis. Curr Orthop Pract. 2017;28(2):153–0.CrossRefGoogle Scholar
  18. 18.
    Boileau P, Trojani C, Walch G, Krishnan SG, Romeo A, Sinnerton R. Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus. J Shoulder Elb Surg. 2001;10(4):299–308.CrossRefGoogle Scholar
  19. 19.
    Mariotti U, Motta P, Stucchi A, di Sant’Angelo FP. Stemmed versus stemless total shoulder arthroplasty: a preliminary report and short-term results. Musculoskelet Surg. 2014;98(3):195–200.CrossRefGoogle Scholar
  20. 20.
    Uschok S, Magosch P, Moe M, Lichtenberg S, Habermeyer P. 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 Elb Surg. 2017;26(2):225–32.CrossRefGoogle Scholar
  21. 21.
    Churchill RS, Chuinard C, Wiater JM, Friedman R, Freehill M, Jacobson S, et al. Clinical and radiographic outcomes of the simpliciti canal-sparing shoulder arthroplasty system: a prospective two-year multicenter study. J Bone Joint Surg Am. 2016;98(7):552–60.CrossRefGoogle Scholar
  22. 22.
    Habermeyer P, Lichtenberg S, Tauber M, Magosch P. Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elb Surg. 2015;24(9):1463–72.CrossRefGoogle Scholar
  23. 23.
    Razmjou H, Holtby R, Christakis M, Axelrod T, Richards R. Impact of prosthetic design on clinical and radiologic outcomes of total shoulder arthroplasty: a prospective study. J Shoulder Elb Surg. 2013;22(2):206–14.CrossRefGoogle Scholar
  24. 24.
    Neer CS. The classic: articular replacement for the humeral head 1955. Clin Orthop Relat Res. 2011;469:2409–21.CrossRefGoogle Scholar
  25. 25.
    Berth A, Pap G. 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. 2013;14(1):31–7.CrossRefGoogle Scholar
  26. 26.
    Ballas R, Béguin L. Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening. J Shoulder Elb Surg. 2013;22(9):e1–6.CrossRefGoogle Scholar
  27. 27.
    Teissier P, Teissier J, Kouyoumdjian P, Asencio G. The TESS reverse shoulder arthroplasty without a stem in the treatment of cuff-deficient shoulder conditions: clinical and radiographic results. J Shoulder Elb Surg. 2015;24(1):45–51.CrossRefGoogle Scholar
  28. 28.
    Engelhardt v LV, Manzke M, Filler TJ, Jerosch J. Short-term results of the reverse Total Evolutive Shoulder System (TESS) in cuff tear arthropathy and revision arthroplasty cases. Arch Orthop Trauma Surg. 2015;135(7):897–904.CrossRefGoogle Scholar
  29. 29.
    Kadum B, Hassany H, Wadsten M, Sayed-Noor A, Sjödén G. Geometrical analysis of stemless shoulder arthroplasty: a radiological study of seventy TESS total shoulder prostheses. Int Orthop (SICOT). 2016;40(4):751–8.CrossRefGoogle Scholar
  30. 30.
    Kadum B, Mukka S, Englund E, Sayed-Noor A, Sjödén G. Clinical and radiological outcome of the Total Evolutive Shoulder System (TESS®) reverse shoulder arthroplasty: a prospective comparative non-randomised study. Int Orthop (SICOT). 2014;38(5):1001–6.CrossRefGoogle Scholar
  31. 31.
    Moroder P, Ernstbrunner L, Zweiger C, Schatz M, Seitlinger G, Skursky R, et al. 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 (SICOT). 2016;40(10):2115–20.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bandar Assiry
    • 1
  • Mitch Armstrong
    • 1
  • Ryan T. Bicknell
    • 2
  1. 1.Department of SurgeryQueen’s University, Kingston Health Sciences CentreKingstonCanada
  2. 2.Departments of Surgery and Mechanical and Materials EngineeringQueen’s University, Kingston Health Sciences CentreKingstonCanada

Personalised recommendations