Monday, May 18, 2020

Stemless shoulder arthroplasty

Screw fixation in stemless shoulder arthroplasty for the treatment of primary osteoarthritis leads to less osteolysis when compared to impaction fixation

These authors compared their results for stemless total shoulder arthroplasty using either screw fixation or impaction in a retrospective study including 39 patients with a mean age of 67 years and a minimum followup of 2 years was performed. Patients were separated into two groups based on the selected implant. In group A (n = 18) a screw fixation design and in group B (n = 21) an impaction type design was used.

In group A the Constant Score (CS) increased from 27.1 to 65.2 points and the Subjective Shoulder value (SSV) from 27.3 to 76.7%. 
No osteolysis of the medial calcar or subsidence of the humeral implant were found in this group. 

In group B the CS increased from 29.0 to 72.6 points and SSV from 33.1 to 85%. Osteolysis of the medial calcar was present in seven patients in this group. 



Comment: Interestingly the clinical results were better in group B which was reported to have a higher rate of osteolysis. In the x-ray immediately above (in which the authors diagnosed "osteolysis", there is superior decentering of the humeral component relative to the genoid suggesting cuff failure and eccentric wear of the glenoid component. See this link

We have yet to find a role for stemless humeral components in our practice of shoulder arthroplasty. To see a YouTube video on how we do the ream and run click on this link.
To see a YouTube of on how we do  total shoulder arthroplasty, click on this link.

===

How you can support research in shoulder surgery Click on this link.

To see our new series of youtube videos on important shoulder surgeries and how they are done, click here.

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages  arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'