Abstract
Shoulder arthroplasty has continued to evolve since its inception. Stemless humeral replacement represents one of the most recent advances and exhibits multiple advantages including preservation of anatomy, decreased risk of intraoperative complication from intramedullary stem placement, and advantages in the revision setting. Indications for the prosthesis have evolved and now include most situations that surgeons traditionally would treat with a stemmed prosthesis. A review of historic, current, and upcoming models is presented, and results for each are discussed. While long-term studies are lacking given the relatively short history of stemless replacement, the current evidence demonstrates favorable results.
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References
Neer II CS. Articular replacement for the humeral head. J Bone Joint Surg Am. 1955;37:215–28.
Boileau P, Walch G, Liotard JP. Etude radio-cinématographique de l’élévation active de l’épaule prothésée. Rev Chir Orthop Reparatrice Appar Mot. 1992;78:355–64.
Walch G, Boileau P. Prosthetic adaptability: a new concept for shoulder arthroplasty. J Should Elbow Surg. 1999;8:443–51.
Raiss P, Edwards TB, Deutsch A, Shah A, Bruckner T, Loew M, Boileau P, Walch G. Radiographic changes around humeral components in shoulder arthroplasty. J Bone Joint Surg. 2014;96:e54(1–9).
Sperling JW, Cofield RH, O’Driscoll SW, Torchia ME, Rowland CM. Radiographic assessment of ingrowth total shoulder arthroplasty. J Should Elbow Surg. 2000;9:507–13.
Campbell JT, Moore RS, Iannotti JP, Norris TR, Williams GR. Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J Should Elbow Surg. 1998;7:406–13.
Levy O, Copeland SA. Cementless surface replacement arthroplasty of the shoulder: 5 to 10 year results with the Copeland Mark-2 prosthesis. J Bone Joint Surg (Br). 2001;83-B:213–21.
Bryant D, Litchfield R, Sandow M, Gartsman GM, Guyatt G, Kirkley A. A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. J Bone Joint Surg. 2005;87:1947–56.
Edwards TB, Kadakia NR, Boulahia A, Kempf JF, Boileau P, Nemoz C, Walch G. A comparison of hemiarthroplasty and total shoulder arthroplasty in the treatment of primary glenohumeral osteoarthritis: results of a multicenter study. J Should Elbow Surg. 2003;12:207–13.
Radnay CS, Setter KJ, Chambers L, Levine WN, Bigliani LU, Ahmad CS. Total shoulder replacement compared with humeral head replacement for the treatment of primary osteoarthritis: a systematic review. J Should Elbow Surg. 2007;16:396–402.
Pearl ML. Proximal humeral anatomy in shoulder arthroplasty: implications for prosthetic design and surgical technique. J Should Elbow Surg. 2005;14:99S–104.
Boileau P, Walch G. The three-dimensional geometry of the proximal humerus: implications for surgical technique and prosthetic design. J Bone Joint Surg (Br). 1997;79-B:857–65.
Roberts SN, Foley AP, Swallow HM, Wallace WA, Coughlan DP. The geometry of the humeral head and the design of prostheses. J Bone Joint Surg (Br). 1992;73-B:647–50.
Iannotti JP, Spencer EE, Winter U, Deffenbaugh D, Williams GR. Prosthetic positioning in total shoulder arthroplasty. J Should Elbow Surg. 2005;14:111S–21S.
Harryman DT, Sidles JA, Harris SL, Lippitt SB. The effect of articular conformity and the size of the humeral head component on laxity and motion after glenohumeral arthroplasty: a study in cadavera. J Bone Joint Surg Am. 1995;77A:555–63.
Karduna AR, Williams GR, Williams JL, Iannotti JP. Glenohumeral joint translations before and after total shoulder arthroplasty. A study in cadavera. J Bone Joint Surg Am. 1997;79:1166–74.
Karduna AR, Williams GR, Williams JL, Iannotti JP. Joint stability after total shoulder arthroplasty in a cadaver model. J Should Elbow Surg. 1997;6:506–11.
Williams GR, Wong DL, Pepe MD, Ta V, Siverberg D, Ramsey ML, Karduna A, Iannotti JP. The effect of articular malposition after total shoulder arthroplasty on glenohumeral translation, range of motion, and subacromial impingement. J Should Elbow Surg. 2001;10:399–409.
Nyffeler RW, Sheikh R, Jacob HA, Gerber C. Influence of humeral prosthesis height on biomechanics of glenohumeral abduction: an in vitro study. J Bone Joint Surg Am. 2004;86-A:575–80.
Jobe CM, Iannotti JP. Limits imposed on glenohumeral motion by joint geometry. J Should Elbow Surg. 1995;4:281–5.
Pearl ML, Kurutz S, Postachini R. Geometric variables in anatomic replacement of the proximal humerus: how much prosthetic geometry is necessary? J Should Elbow Surg. 2009;18:366–70.
Wirth MA, Ondrla J, Southworth C, Kaar K, Anderson BC, Rockwood CA. Replicating proximal humeral articular geometry with a third-generation implant: a radiographic study in cadaveric shoulders. J Should Elbow Surg. 2007;16:11S–6.
Pritchett JW. Long-term results and patient satisfaction after shoulder resurfacing. J Should Elbow Surg. 2011;20:771–7.
Vanhees M, Jaspars KCJ, van Riet R, Verborgt O, Declerq G. Stemless revision of a failed hemiarthroplasty: case report and surgical technique. J Should Elbow Surg. 2013;22:e14–8.
Boyd AD, Thornhill TS, Barnes CL. Fractures adjacent to humeral prostheses. J Bone Joint Surg. 1992;74:1498–504.
Thomas SR, Wilson AJ, Chambler A, Harding I, Thomas M. Outcome of Copeland surface replacement arthroplasty. J Should Elbow Surg. 2005;14:485–91.
Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz SM. Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Should Elbow Surg. 2010;19:1115–20.
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 Should Elbow Surg. 2001;10:299–308.
Habermeyer P, Lichtenberg S, Tauber M, Magosch P. Midterm results of stemless shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg 2015;24: 1463–72.
Kim MS, Kovacevic D, Milks RA, Jun BJ, Rodriguez E, DeLozier KR, Derwin KA, Iannotti JP. Bone graft substitute provides metaphyseal fixation for a stemless humeral implant. Orthopedics. 2015;38:e597–603.
Dawson CK, Rolf RH, Holovacs TF. The management of localized articular cartilage lesions of the humeral head in the athlete. Oper Tech Sports Med. 2008;16:14–20.
Scalise JJ, Miniaci A, Iannotti JP. Resurfacing arthroplasty of the humerus: indications, surgical technique and clinical results. Tech Should Elbow Surg. 2007;8:152–60.
Uribe JW, Botto-van Bemden A. Partial humeral head resurfacing for osteonecrosis. J Should Elbow Surg. 2009;18:711–6.
Delaney RA, Freehill MT, Higgins LD, Warner JJP. Durability of partial head resurfacing. J Should Elbow Surg. 2014;23:e14–22.
Sweet SJ, Takara T, Ho L, Tibone JE. Primary partial humeral head resurfacing: outcomes with the HemiCAP implant. Am J Sports Med. 2015;43:579–87.
Mackenzie DB. The antero-superior exposure for total shoulder replacement. Orthop Traumatol. 1993;2:71–7.
Bosali KI, Wirth MA, Rockwood CA. Complications of total shoulder arthroplasty. J Bone Joint Surg. 2006;88-A:2279–92.
Huguet D, DeClerq G, Rio B, Teissier J, Zipoli B. Results of a new stemless shoulder prosthesis: radiologic proof of maintained fixation and stability after a minimum of three years’ follow-up. J Should Elbow Surg. 2010;19:847–52.
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 Should Elbow Surg. 2015;24:45–51.
Ballas R, Beguin L. Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening. J Should Elbow Surg. 2013;22:e1–6.
Magosch P, Habermeyer P, Bachmaier S, Metcalfe N. Biomechanische grundlagen des metaphysear verankerten humeruskopfersatzes. Obere Extremiteat. 2012;7:11–6.
Schoch C, Huth J, Aghajev E, Bauer G, Mauch F. Diemetaphysear verankerte Prothese bei posttraumatischer und primarer Omarthrose, kurzfristige ergebnisse. Obere Extremitat. 2011;4:275–81. German.
Brunner UH, Fruth M, Reuckl K, Magosch P, Tauber M, Resch H, Habermeyer P. Die schaftfreie Eclipse -prothese - indikation und mittelfristige ergebnisse. Eine prospektive Multicenterstudie. Obere Extremiteat. 2012;7:22–8. German.
Mariotti U, Motta P, Stucchi A, Ponti di Sant’Angelo F. Stemmed versus stemless total shoulder arthroplasty: a preliminary report and short-term results. Musculoskelet Surg. 2014;98:195–200.
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 two years follow-up. J Orthop Traumatol. 2013;14:31–7.
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Lee, B., Abboud, J. (2016). Stemless Humeral Head Replacement. In: Armstrong, A., Murthi, A. (eds) Anatomic Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-29164-2_5
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DOI: https://doi.org/10.1007/978-3-319-29164-2_5
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