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

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Musculoskeletal research

Background:

• Stemless reverse total shoulder arthroplasty (rTSA) is a modification of traditional Grammont rTSA.
• Potential benefits include bone stock preservation, easier revision, reduced blood loss, and shorter surgery times.
• Less research has focused on stemless rTSA compared to stemmed implants.

Purpose of the Study:

• To systematically review and analyze the functional outcomes and complication rates of stemless rTSA.
• To compare the efficacy of stemless rTSA with traditional stemmed implants.

Main Methods:

• A systematic literature search was performed following PRISMA guidelines.
• Searches were conducted in PubMed, EMBASE, and Cochrane databases.
• Included 15 studies encompassing 657 shoulders in 648 patients.

Main Results:

• Stemless rTSA showed significant improvements in functional outcomes and range of motion (ROM).
• No significant differences in abduction or forward flexion ROM between stemless and stemmed implants.
• Stemless implants showed superior internal rotation (SMD -0.79, 95% CI: -1.56, -0.03).
• Similar rates of revision (5.5%) and complications (13.4%) were observed for stemless rTSA across studies.

Conclusions:

• Stemless rTSA achieves comparable functional outcomes and ROM to stemmed designs.
• Stemless implants offer superior internal rotation.
• Further research is required to validate proposed advantages like reduced blood loss and surgical time, and to assess long-term durability.