Mid-term outcomes of a stemless ceramic head anatomic total shoulder replacement

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Clinical Research

Background:

• Stemless anatomic shoulder replacement (aTSR) shows promise for treating glenohumeral osteoarthritis.
• Ceramic-on-polyethylene articulations may reduce wear particle generation compared to metal-on-polyethylene.
• Mid-term clinical and radiographic outcomes of this specific implant combination require evaluation.

Purpose of the Study:

• To assess the clinical and radiographic results of stemless aTSR using a ceramic head and polyethylene glenoid component.
• To evaluate patient-reported outcomes and functional improvements at mid-term follow-up.
• To determine the incidence of complications such as glenoid radiolucency and osteolysis.

Main Methods:

• Prospective study of 92 patients undergoing stemless aTSR for glenohumeral osteoarthritis.
• Utilized a stemless humeral component with a ceramic head and a cemented polyethylene glenoid.
• Clinical outcomes (ASES, Constant, SPADI, DASH, VAS pain, satisfaction, ROM) assessed at 2 and 5 years.
• Radiographic assessment included glenoid radiolucent lines and humeral osteolysis.

Main Results:

• At 5-year follow-up (n=74), active elevation improved from 91.3° to 151.1° (p<0.001).
• Significant improvements noted in ASES (41.6 to 94.3), SPADI (62.9 to 4.3), and VAS pain (5.6 to 0.4).
• 96% patient satisfaction; 62 cases showed no glenoid radiolucent lines; one revision for glenoid loosening.

Conclusions:

• Stemless anatomic shoulder replacement with a ceramic head and polyethylene glenoid demonstrates favorable 5-year clinical and radiographic outcomes.
• The implant combination provides significant functional improvement and high patient satisfaction.
• Low rates of radiographic complications suggest good implant stability and durability.