Abstract
BackgroundThe latest generation of shoulder arthroplasty includes canal-sparing respectively stemless designs that have been developed to allow restoration of the glenohumeral center of rotation independently from the shaft, and to avoid stem-related complications. The stemless prosthesis design has also recently been introduced for use in reverse arthroplasty systems.MethodsWe systematically reviewed the literature for studies of currently available canal-sparing respectively stemless shoulder arthroplasty systems. From the identified series, we recorded the indications, outcome measures, and humeral-sided complications.ResultsWe identified 11 studies of canal-sparing respectively stemless anatomic shoulder arthroplasty implants, published between 2010 and 2016. These studies included 929 cases, and had a mean follow-up of 26 months (range, 6 to 72 months). The rates of humeral component-related complications ranged between 0 and 7.9 %. The studies reported only a few isolated cases of complications of the humeral component. Some arthroplasty systems are associated with radiological changes, but without any clinical relevance.ConclusionsAll of the published studies of canal-sparing respectively stemless shoulder arthroplasty reported promising clinical and radiological outcomes in short to midterm follow-up. Long-term studies are needed to demonstrate the long-term value of these kind of implants.
Highlights
The latest generation of shoulder arthroplasty includes canal-sparing respectively stemless designs that have been developed to allow restoration of the glenohumeral center of rotation independently from the shaft, and to avoid stem-related complications
Biomet Total Evolutive Shoulder System The first available canal-sparing respectively stemless implant was the Biomet Total Evolutive Shoulder System (TESS, Biomet, Warsaw, IN, USA), which was first used in Europe in 2004 (Fig. 1)
Six different canal-sparing respectively stemless humeral implants are presently available on the market, four of which are described in published studies
Summary
The latest generation of shoulder arthroplasty includes canal-sparing respectively stemless designs that have been developed to allow restoration of the glenohumeral center of rotation independently from the shaft, and to avoid stem-related complications. Canal-sparing respectively stemless prostheses were first available in Europe in 2004 Such implants lack a conventional diaphyseal humeral stem, are based on metaphyseal fixation, and do not violate the humeral canal. Canalsparing respectively stemless shoulder arthroplasty must not be confused with resurfacing techniques that aim to restore joint congruency by preserving the majority of the humeral head bone stock and implantation of a metallic cap over the remaining humeral head bone stock [3, 12,13,14,15,16,17,18]
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