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Updated: Jun 5, 2025
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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Stemmed VS stemless total shoulder arthroplasty: a systematic review and meta-analysis
Florian Schönweger1, Lorenzo Massimo Oldrini2, Pietro Feltri1
1Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, 6900, Switzerland.
Archives of Orthopaedic and Trauma Surgery
|December 12, 2024
Summary
Stemless total shoulder arthroplasty (TSA) offers slight external rotation benefits but has higher deep infection rates. Stemmed TSA shows similar clinical outcomes with fewer infections, making both viable options for glenohumeral osteoarthritis.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Research
Background:
- Anatomic total shoulder arthroplasty (TSA) is a common treatment for glenohumeral osteoarthritis (OA) in patients with intact rotator cuffs.
- Evaluating stemmed versus stemless TSA designs is crucial for optimizing patient outcomes and minimizing complications.
Approach:
- A systematic review and meta-analysis adhering to PRISMA guidelines was conducted.
- Included were comparative studies on stemmed vs. stemless TSA in adult OA patients, with literature searches up to January 2024.
- Clinical outcomes (Constant and Murley Score, Range of Motion) and complications were analyzed using Downs and Black's checklist for quality assessment.
Key Points:
- No significant differences in Constant and Murley Score or Range of Motion were observed between stemmed and stemless TSA.
- Stemless TSA showed a statistically significant improvement in external rotation (3.9° higher).
- Deep infection rates were higher in the stemless group (2.2%) compared to the stemmed group (0.8%).
Conclusions:
- Both stemmed and stemless TSA provide comparable clinical outcomes for glenohumeral osteoarthritis.
- Stemless TSA may offer a marginal benefit in external rotation, but its clinical significance is uncertain.
- Stemmed TSA demonstrated a lower deep infection rate, suggesting a potential advantage in safety profiles.
