The TESS reverse shoulder arthroplasty without a stem in the treatment of cuff-deficient shoulder conditions: clinical and radiographic results

Teissier, Philippe; Teissier, Jacques; Kouyoumdjïan, Pascal; Asencio, G.

doi:10.1016/j.jse.2014.04.005

Cited by 77 publications

(54 citation statements)

References 29 publications

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“…No general loosening of the humeral component was noted in both groups, which confirms previous findings [13][14][15][16]. While in the RSA group with stem 29 % of the cases showed radiolucencies or visible bone density loss in one or two of eight zones, in none of the cases more than two zones were affected.…”

Section: Discussionsupporting

confidence: 89%

“…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%

“…Each zone was assessed for radiolucencies and the presence of visible bone density loss. The inclination of the humeral component (neck-shaft angle, NSA) was measured on the apradiographs according to Teissier et al [14] Inferior scapular notching was assessed according to Sirveaux et al on apradiographies [18]. Additionally, humeral component subsidence was analyzed in both groups.…”

Section: Radiological Assessmentmentioning

confidence: 99%

“…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: 89%