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Stemless Humeral Implants in Total Shoulder Arthroplasty
Eugene W Brabston1, Edward V Fehringer, Matthew T Owen
1From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL (Dr. Brabston, Dr. Owen, and Dr. Ponce), Columbus Orthopaedic and Sports Medicine Clinic, Columbus, NE (Dr. Fehringer).
The Journal of the American Academy of Orthopaedic Surgeons
|December 21, 2019
Summary
Stemless humeral implants offer bone preservation and reduced surgical risks, but rely on proximal bone quality for fixation. This review examines their biomechanics, technique, and clinical outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Advancements in shoulder arthroplasty have led to the development of both short stem and stemless humeral implants.
- Stemless designs aim to improve bone preservation and reduce complications associated with traditional stemmed implants.
Purpose of the Study:
- To review the existing evidence on stemless humeral implants.
- To analyze the biomechanical advantages and disadvantages of stemless fixation.
- To evaluate the surgical technique and clinical outcomes associated with stemless humeral implants.
Main Methods:
- Literature review of studies on stemless humeral implants.
- Analysis of biomechanical data comparing stemless and stemmed implants.
- Synthesis of reported clinical outcomes and surgical techniques.
Main Results:
- Stemless implants offer potential benefits such as greater bone preservation, reduced stress shielding, and decreased surgical time.
- Potential drawbacks include reliance on proximal bone quality and subscapularis fixation strength.
- Clinical outcomes are promising but require further long-term investigation.
Conclusions:
- Stemless humeral implants represent a promising alternative in shoulder arthroplasty.
- Careful patient selection based on bone quality is crucial for successful outcomes.
- Further research is needed to fully establish the long-term efficacy and safety of these implants.
