[Options and limits of stemless shoulder prostheses]

Currently there are five manufacturers offering stemless implants for shoulder joint replacement. A total number of almost 10,000 stemless implants have been used in shoulder arthroplasty since 2004. There are two different types of metaphyseal anchorage, one obtained by impaction of a fin system and in the other implant system cage screw fixation is used. Regarding revision surgery the different types of implants show varying advantages and disadvantages in terms of secondary approach to the glenoid and the metaphyseal component. Because of the small number of cases and short period of observation at the present time none of the implant systems show a decisive superiority. In sclerotic bone the cage screw system seems to be advantageous whereas impaction using the fin system seems to be preferable in osteoporotic bone and conditions with defects of the bone. A prerequisite for all types of stemless shoulder implants is good quality bone. There should not be bony defects under the surface of the area of head resection. Stemless implants are not indicated for acute fractures.