Stemless shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Medical Device Design

Background:

• Stemless shoulder arthroplasty emerged in 2005, providing an alternative to traditional stemmed implants.
• It is now a viable option for both anatomical and reverse shoulder replacements.
• The design was motivated by achieving epiphyso-metaphyseal fixation via an impacted anchor.

Purpose of the Study:

• To review the evolution and current status of stemless shoulder arthroplasty.
• To compare the outcomes of stemless versus traditional stemmed implants.
• To discuss the advantages, limitations, and future directions of stemless technology.

Main Methods:

• Review of 15 years of clinical experience with stemless shoulder arthroplasty systems.
• Analysis of commercially available stemless implant features (anatomical and reverse).
• Comparison of outcomes with traditional stemmed total shoulder arthroplasty (TSA) at a mean 10-year follow-up.

Main Results:

• Stemless TSA outcomes are comparable to traditional stemmed TSA at a mean 10-year follow-up.
• Advantages include simpler implantation, adaptability, no stress-shielding, and reduced risks.
• Limitations involve insufficient bone stock and poor bone quality, particularly for reverse designs.

Conclusions:

• Stemless shoulder arthroplasty is a mature and effective option for shoulder replacement.
• Careful patient selection is crucial, considering bone quality and morphology.
• Future developments should focus on improving longevity through tribology and enhancing convertibility and reverse configurations.