Stemmed versus stemless total shoulder arthroplasty: a comparison of operative times

Anastasio, Albert T.; Okafor, Chinedu; Garrigues, Grant E.; Klifto, Christopher S.; Lassiter, Tally; Anakwenze, Oke

doi:10.1053/j.sart.2021.05.013

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…Wilson et al 9 found that each 20-minute increase in surgical time increased the risk for all complications by 24%. Our findings are consistent with those of Anastasio et al 6 who reported a nearly 14-minute shorter mean surgical time among the stemless cohort compared with the stemmed cohort, even when adjusting for BMI. It is not clear from their study, however, whether the stemmed implants were of the SL or SS design or whether any of the stemmed implants required the use of cement, factors which could influence the surgical time.…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, several studies included both cemented and noncemented stems, which may have confounded their findings. 3 , 4 More recently, Anastasio et al 6 reported on a nearly 14-minute shorter surgical time for stemless compared with SS total shoulder arthroplasty, even when controlling for body mass index (BMI). By contrast, Wiater et al, 7 in a multicenter randomized controlled trial comparing a stemless anatomic total shoulder arthroplasty (aTSA) with the same manufacturer's noncemented SS implant, found no difference in surgical time.…”

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confidence: 99%

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A Comparison of Operative Time and Intraoperative Blood Volume Loss Between Stemless and Short‐stem Anatomic Total Shoulder Arthroplasty: A Single Institution's Experience

Gruson

Stallone

et al. 2022

JAAOS Glob Res Rev

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Introduction: There has been increasing interest in the use of stemless humeral implants for total shoulder arthroplasty when compared with both short-stem (SS) and standard-length implants. Although evidence for decreased surgical time and blood loss exists for stemless versus standard-length stems, far less literature exists comparing these clinical parameters for stemless versus SS implants. Methods: A retrospective review of consecutive anatomic total shoulder arthroplasty (aTSA) cases conducted by a single, fellowshiptrained shoulder surgeon was undertaken from January 2016 through January 2022 with the exception of March 2020 through January 2021 secondary to the COVID-19 pandemic. Demographic patient and surgical data, including age, sex, body mass index, American Society of Anesthesiologists score, age-adjusted Charlson Comorbidity Index, prior ipsilateral shoulder arthroscopy, surgical time, use of a Hemovac drain and/or tranexamic acid, hospital length of stay (LOS), and both postoperative day #1 (POD 1) and discharge visual analog scores. The use of a stemless or SS implant was recorded. Intraoperative total blood volume loss (TBVL) was calculated, in addition to the need for either intraoperative or postoperative transfusions. Nonparametric analysis of covariance was used to examine effects of stemless versus SS aTSA on surgical time and intraoperative TBVL adjusted for demographic, clinical, and surgical variables. Results: There were 47 SS and 83 stemless anatomic implants included, of which 74 patients (57%) overall were women. The median surgical time for the stemless cohort was 111 minutes (IQR 96-130) versus 137 minutes (IQR 113-169) for the SS cohort (P , 0.00001). The median intraoperative TBVL for the stemless cohort was 298.3 mL ) versus 359.7 mL (IQR 253.9-415.0) for the SS cohort (P = 0.05). After multivariable regression analysis, use of

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%