Nine-year outcome after anatomic stemless shoulder prosthesis: clinical and radiologic results

J Shoulder Elbow Surg. 2017 Sep;26(9):1609-1615. doi: 10.1016/j.jse.2017.02.017. Epub 2017 Apr 11.


Background: Several stemless shoulder implants are available on the market, but only a few studies have presented results with sufficient mid- to long-term follow-up. The present study evaluated clinical and radiologic outcomes 9 years after anatomic stemless shoulder replacement.

Methods: This is a prospective cohort study evaluating the stemless shoulder prosthesis since 2005. Anatomic stemless shoulder replacement using a single prosthesis was performed in 49 shoulders; 17 underwent total shoulder replacement, and 32 underwent hemiarthroplasty. Forty-three patients were clinically and radiologically monitored after a mean of 9 years (range, 90-127 months; follow-up rate, 88%). The indications for shoulder replacement were primary osteoarthritis in 7 shoulders, post-traumatic in 24, instability in 7, cuff tear arthropathy in 2, postinfectious arthritis in 1, and revision arthroplasty in 2.

Results: The Constant-Murley Score improved significantly from 52% to 79% (P < .0001). The active range of motion also increased significantly for flexion from 101° to 118° (P = .022), for abduction from 79° to 105° (P = .02), and for external rotation from 21° to 43° (P < .0001). Radiologic evaluation revealed incomplete radiolucency in 1 patient without clinical significance or further intervention. No revision caused by loosening or countersinking of the humeral implant was observed.

Conclusions: The 9-year outcome after stemless shoulder replacement is comparable to that of third- and fourth-generation standard shoulder arthroplasty.

Keywords: Stemless shoulder arthroplasty; canal-sparing shoulder arthroplasty; hemiarthroplasty; post-traumatic osteoarthritis; primary osteoarthritis; shoulder; total shoulder arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Shoulder
  • Cohort Studies
  • Female
  • Hemiarthroplasty
  • Humans
  • Humerus / diagnostic imaging
  • Humerus / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Range of Motion, Articular
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / surgery*
  • Shoulder Prosthesis*
  • Treatment Outcome
  • Young Adult