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Long-Term Radiographic Changes in Stemless Press-Fit Total Shoulder Arthroplasty
Sascha Beck1,2, Theodor Patsalis3, André Busch4
1Department of Orthopedics and Trauma Surgery, Universität Duisburg-Essen, Medizinische Fakultät, Essen.
Zeitschrift Fur Orthopadie Und Unfallchirurgie
|February 26, 2020
Summary
Anatomic stemless total shoulder arthroplasty (TSA) showed mild stress shielding in 38.4% of cases but stable fixation and improved clinical outcomes. This stemless design offers comparable long-term performance to stemmed TSA.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Stemmed humeral implants are standard in total shoulder arthroplasty (TSA).
- Bone preservation is a key trend in TSA design.
- Stemless implants may better mimic natural bone stress patterns.
Purpose of the Study:
- To evaluate long-term radiographic changes at the proximal humerus using anatomical stemless press-fit TSA.
- To assess the bone preservation and fixation of stemless TSA designs.
Main Methods:
- Retrospective review of 30 shoulders (25 patients) who received anatomic stemless TSA (TESS, Biomet) between 2008-2010.
- Mean follow-up of 94 months for clinical and radiographic assessment.
Main Results:
- Mild stress shielding observed in 38.4% of stemless implants, with 80% of changes being mild.
- Stable fixation of the stemless humeral implant was confirmed.
- Significant improvement in clinical scores (VAS, Quick-DASH, Constant) despite radiographic changes.
Conclusions:
- Anatomical stemless press-fit TSA demonstrates favorable outcomes regarding stress shielding.
- Clinical performance over 8 years appears comparable to conventional stemmed TSA.
- Radiographic changes did not negatively impact clinical outcomes.
