Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening

Ballas, Richard; Béguin, L.

doi:10.1016/j.jse.2012.12.005

Cited by 80 publications

(48 citation statements)

References 13 publications

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“…In our series one patient (132°humeral component) presented with a post-traumatic dislocation which was successfully treated with a higher liner and subscapularis reinsertion. This instability rate (4 %) is comparable with rates of previous reports for stemless RSA (0 %, 1 %, 2 %, and 13 %) [13][14][15][16], as well as the traditional Grammont design (4 %) [22].…”

Section: Discussionsupporting

confidence: 86%

“…The lack of a stem allows free placement of the humeral component in all planes which on the one hand creates a great opportunity for the surgeon to freely choose a combination of retroversion, offset, and inclination, but on the other hand represents a challenge to the surgeons technical skills to obtain the desired positioning. Accordingly, the most common complication reported in previous studys of the same stemless RSA implant was early humeral component break-out (0 %, 2 %, 2 %, and 13 %) not only attributed to poor bone quality but also implantation mistakes [13][14][15][16]. In our series with strict selection criteria (selection rate <20 %) no early or late humeral component break-out occurred.…”

Section: Discussionmentioning

confidence: 43%

“…Accordingly only a few outcome reports on stemless RSA can be found in the literature. While the published short to mid-term clinical and radiological outcomes seem to be promising all published case series lack an outcome assessment by an independent observer [13][14][15][16], except for one report regarding RSA with mini-stem [17].…”

Section: Introductionmentioning

confidence: 99%

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Short to mid-term results of stemless reverse shoulder arthroplasty in a selected patient population compared to a matched control group with stem

Moroder

Ernstbrunner

Zweiger³

et al. 2016

International Orthopaedics (SICOT)

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Purpose Little scientific evidence on the clinical and radiological outcome after stemless reverse shoulder arthroplasty (RSA) exists. The hypothesis of this study was that stemless RSA has an inferior outcome compared to RSA with stem. Methods All cases of cuff-arthropathy fullfilling strict selection criteria (selection rate 18.4 %) were treated with stemless RSA between 2009 and 2013. Twenty nine of 37 cases (78.4 %) were clinically and radiologically examined by an independent observer. Twenty four of the 29 cases could be matched with 24 patients that underwent conventional stemmed RSA at a different institution based on the following criteria: indication (cuff-arthropathy), age (within 5 years), gender, and time of follow-up (within 2 years). Clincial and radiological outcomes of both groups were compared. Results After mean follow-up of 35 months (range 24-75) no significant difference regarding constant score, ASES, subjective shoulder value, pain score, patient satisfaction, strength, and range of motion was detected. One case of traumatic dislocation was observed in the stemless RSA group. Scapular notching grade 1 was detected in two cases of the stemless group while in the stemmed group five cases with grade 1 and four cases with grade 2 notching were observed. Average post-operative humeral component inclination (neck-shaft angle) in the stemless RSA group (134.4°) was significantly steeper than in the stemmed RSA group (155°) (p < 0.001). No loosening of the humeral component was observed in both groups. Conclusion At short to mid-term follow-up, stemless RSA does not feature inferior clinical or radiological outcomes in a strictly selected patient population.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 43%

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Short to mid-term results of stemless reverse shoulder arthroplasty in a selected patient population compared to a matched control group with stem

Moroder

Ernstbrunner

Zweiger³

et al. 2016

International Orthopaedics (SICOT)

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“…The humeral implant stability was of concern initially. With the numbers given and considering eventual limitations related to the volume of this study, we found encouraging results with adequate humeral fixation in both anatomical and reverse versions [1,13,14]. In our study, with a mean follow-up of 39 months (15-66 months), there were no signs of humeral loosening after stemless implantation.…”

Section: Discussionmentioning

confidence: 49%

Clinical and radiological outcome of the Total Evolutive Shoulder System (TESS®) reverse shoulder arthroplasty: a prospective comparative non-randomised study

Kadum

Mukka

Englund

et al. 2014

International Orthopaedics (SICOT)

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Purpose The aims of this study were to assess the function and quality of life after the Total Evolutive Shoulder System (TESS) reverse shoulder arthroplasty (RSA), to evaluate the radiological stability of the stemless version and to address the effect of arm lengthening and scapular notching (SN) on the outcome. Methods This was a prospective comparative nonrandomised study. A total of 37 consecutive patients (40 shoulders) underwent TESS RSA between October 2007 and January 2012; 16 were stemless and 26 were stemmed. At a mean follow-up of 39 months (15-66), we evaluated range of motion (ROM), pain and functional outcome with QuickDASH and quality of life with EQ-5D score. Radiologically, component positioning, signs of loosening, SN and arm length difference were documented. Results We found a significant improvement in functional outcome and reduction of pain in both stemmed and stemless groups. No humeral loosening was evident, but there were four glenoid loosenings. In 12 shoulders that developed SN, seven already had scapular bone impression (SBI) evident on initial post-operative radiographs. Glenoid overhang seemed to decrease the risk of SN. Arm lengthening was associated with better EQ-5D but did not influence ROM or functional outcome.Conclusions Reverse shoulder arthroplasty markedly improved shoulder function. SN is of concern in RSA, but proper positioning of the glenoid component may prevent its development.

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“…Ballas et al followed 56 patients for at least 38 months but on average 58 months [28]. The mean Constant score was 62 at the most recent follow-up.…”

Section: Biometmentioning

confidence: 99%

Total shoulder arthroplasty: are the humeral components getting shorter?

Harmer

Throckmorton

Sperling

2016

Curr Rev Musculoskelet Med

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Each generation of total shoulder arthroplasy has improved on the previous. The newest humeral component innovation is shortening the humeral component or eliminating the stem entirely to rely on stemless fixation in the humeral metaphysis. This offers theoretical advantages of preserved bone stock, less stress shielding, eliminating the diaphyseal stress riser, ease of stem removal at revision, and humeral head placement independent from the humeral shaft axis. There are a number of short term cohorts that have shown low complication rates and outcomes similar to previous generations of stemmed humeral components. Longer term and better designed studies are needed in order for short stems and stemless components to become the standard of care.

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Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening

Cited by 80 publications

References 13 publications

Short to mid-term results of stemless reverse shoulder arthroplasty in a selected patient population compared to a matched control group with stem

Short to mid-term results of stemless reverse shoulder arthroplasty in a selected patient population compared to a matched control group with stem

Clinical and radiological outcome of the Total Evolutive Shoulder System (TESS®) reverse shoulder arthroplasty: a prospective comparative non-randomised study

Total shoulder arthroplasty: are the humeral components getting shorter?

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