Stemless anatomic total shoulder arthroplasty: a systematic review and meta-analysis

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Medical Device Engineering

Background:

• Stemless anatomic total shoulder arthroplasty (TSA) is a treatment for shoulder osteoarthritis and degenerative diseases.
• Proposed advantages include bone preservation, reduced operative time, and easier revision compared to stemmed TSA.

Purpose of the Study:

• To systematically review and analyze the outcomes of stemless anatomic TSA.
• To compare functional outcomes, complication rates, operative time, and blood loss between stemless and stemmed TSA.

Main Methods:

• A systematic literature search was conducted across MEDLINE, Embase, PubMed, and CENTRAL.
• Twenty-two studies involving 962 patients undergoing stemless TSA were included in the review.
• Meta-analysis was performed on comparative studies between stemless and stemmed TSA.

Main Results:

• Stemless TSA demonstrated significant improvements in range of motion and functional scores.
• No significant differences were found in postoperative Constant scores or complication rates between stemless and stemmed TSA.
• Stemless TSA showed significantly shorter operative times and decreased intraoperative blood loss compared to stemmed TSA.

Conclusions:

• Stemless anatomic TSA provides comparable functional outcomes and complication rates to stemmed TSA.
• The stemless approach offers advantages of reduced operative time and blood loss.
• Long-term implant durability remains an area for future research.