Abstract
Background: Stemless shoulder arthroplasty (SSA) is used to anatomically reconstruct proximal humerus geometry and preserve proximal humerus bone stock. The current literature lacks 3D-analysis of pre- and postoperative proximal humeral anatomy after SSA. The aim of this study was to prospectively analyze the humeral head anatomy using a computer-assisted topography mapping technique after SSA in relation to the preoperative status and the contralateral (not affected) side. Methods: Twenty-nine patients (mean age: 63.5 ± 11.7 years) affected by primary shoulder osteoarthritis and treated with SSA were included. Preoperative and postoperative CT scans of the affected and contralateral sites were analyzed regarding joint geometry. Clinical outcome was assessed by Constant and Disabilities of the Arm, Shoulder and Hand (DASH) score shortly before and one year after surgery. Results: Clinical outcome improved significantly. No correlation between clinical outcome and the evaluated anatomical parameters was found. There was a significant decrease of the humeral head height (p < 0.01) and radius (p = 0.03) in the preoperative versus the postoperative joint geometry. The comparison to the contralateral site showed also a significant decrease of the humeral head height (p < 0.01). All other parameters showed no significant differences. Conclusion: Proximal humeral anatomy can be almost anatomically reconstructed by SSA. Solely the humeral head height differs significantly to the preoperative as well as contralateral morphology.
Highlights
Shoulder arthroplasty was initially introduced in the 1950s by Charles Neer for the treatment of proximal humerus fractures [1,2]
9 male and 20 female patients participated in the study
In 12 cases, surgery was performed on the right shoulder; in 17 cases, on the left shoulder
Summary
Shoulder arthroplasty was initially introduced in the 1950s by Charles Neer for the treatment of proximal humerus fractures [1,2]. The indication for shoulder arthroplasty was widened for shoulder osteoarthritis and many techniques and designs were developed to anatomically reconstruct the joint morphology and to achieve almost normal joint function. During this process, many stem-related complications including intraoperative humeral fracture, loosening, stress shielding, or periprosthetic humeral fracture were described [3]. In 2004, the first stemless shoulder arthroplasty implant was introduced by Biomet in Europe [2,4] and, since many other stemless shoulder endoprostheses were developed [5] The advantages of this type of prosthesis are obvious: the elimination of the humeral stem and the isolated metaphyseal fixation allow for a more flexible reconstruction of the anatomical morphology in degeneratively changed and deformed shoulder joints. The humeral head height differs significantly to the preoperative as well as contralateral morphology
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
