Survival of stemless humeral head replacement in anatomic shoulder arthroplasty: a prospective study
These authors state that the "overall revision rate of standard stemmed shoulder arthroplasty is given as between 5.1% and 7.9% after a minimum follow-up period of 10 years."
The overall revision rate in their study of stemless shoulder arthroplasty in this study was 15.1% after a minimum follow-up period of 8.75 years (average 10.5 years, range 8.75-13 years).
They report on 75 patients ((40 hemi–shoulder arthroplasties [HSAs] and 35 total shoulder arthroplasties [TSAs]) with a mean age of 57 years at surgery; 38 women and 37 men) with the Eclipse humeral implant.
The age- and sex-normalized Constant-Murley score improved significantly (P < .0001) from 56% preoperatively to 90% postoperatively. There was no significant difference in preoperative CMS vs. postoperative CMS between HSA (44.8 points vs. 67.1 points, and TSA (44.4 points vs. 68.9 points.
They observed no loosening of the stemless humeral head component. Upward migration of the humeral head was observed in 17.5% of patients (21.6% with HSA and 11.5% with TSA.
At follow-up, 18.3% of patients had rotator cuff deficiency (13.9% with HSA and 25% with TSA).
9.3% of stemless shoulder arthroplasties were revised to reverse TSAs (5% of HSAs as were 14.3% of TSAs.
The reasons for revision surgery were rotator cuff deficiency and glenoid loosening.
They observed an incomplete radiolucent line < 2 mm in 30.4% and glenoid loosening in 11.4% of cemented glenoid components.
Comment: This paper demonstrates improvement in shoulder comfort and function with the Eclipse humeral implant. It does not, however, demonstrate results that are superior to those achieved with a standard humeral implant. These authors state that the "overall revision rate of standard stemmed shoulder arthroplasty is given as between 5.1% and 7.9% after a minimum follow-up period of 10 years." The overall revision rate in their study of stemless shoulder arthroplasty in this study was 15.1% after a minimum follow-up period of 8.75 years (average 10.5 years, range 8.75-13 years).
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