Two-Year Functional and Radiographic Outcomes Following Large Lesser Tuberosity Osteotomy in Stemless Anatomic Total...

Area of Science:

• Orthopedic Surgery
• Shoulder Arthroplasty
• Biomechanics

Background:

• Debate exists regarding optimal subscapularis management in anatomic total shoulder arthroplasty (aTSA).
• No prior studies have reported 2-year outcomes for stemless aTSA using a large lesser tuberosity osteotomy.

Purpose of the Study:

• To evaluate functional and radiographic outcomes of stemless aTSA with a large lesser tuberosity osteotomy at a minimum of 2 years.
• To assess healing rates, implant stability, and patient-reported outcomes.

Main Methods:

• Retrospective review of patients undergoing stemless aTSA with large lesser tuberosity osteotomy.
• Collected data on demographics, active range of motion, subscapularis strength, pain (VAS), and functional scores (ASES).
• Radiographic assessment for osteotomy healing and implant loosening.

Main Results:

• Significant improvements in elevation, external rotation, VAS pain, and ASES scores at 2 years (P < 0.001).
• Internal rotation strength comparable to the contralateral limb (P = 0.38).
• 93% complete radiographic healing of the osteotomy, with no displacement; 13.6% required cerclage wire removal with comparable outcomes.

Conclusions:

• Stemless aTSA with large lesser tuberosity osteotomy demonstrates excellent functional and radiographic results.
• High healing rates and restored internal rotation strength are achieved.
• While some patients require wire removal, overall outcomes remain favorable.