Authom T, Lascar T, Wahab H, Gournay A, Beaudouin E, Muller JH, Saffarini M, Nourissat G. Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder
Arthroplasty.
J Shoulder Elb Arthroplast 2023;
7:24715492231163055. [PMID:
36968299 PMCID:
PMC10031594 DOI:
10.1177/24715492231163055]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/24/2023] [Accepted: 02/19/2023] [Indexed: 03/24/2023] Open
Abstract
Background
The purpose was to report mid-term to long-term clinical outcomes in a
multicentre series of patients who received stemless total shoulder
arthroplasty (TSA). The hypothesis was that stemless TSA would be a safe and
effective treatment with satisfactory clinical outcomes.
Methods
Authors retrospectively reviewed records of 62 stemless TSAs implanted
between March 2013 and December 2014. Six were excluded because they had
fractures or muscular impairment, which left 56: primary osteoarthritis
(n = 49), rheumatoid arthritis (n = 4), avascular necrosis (n = 1), or
glenoid dysplasia (n = 2). Outcomes were absolute Constant Score (CS),
age-/sex-adjusted CS, and the American Shoulder and Elbow Surgeons (ASES)
score. Proportions of patients that achieved substantial clinical benefits
for absolute CS and ASES scores were determined.
Results
Of the 56 patients, 8 (14%) died (unrelated to TSA), 5 (9%) were lost to
follow-up, and 2 (4%) refused participation. One patient was reoperated for
infection with implant removal (excluded from analysis), and one for
periprosthetic fracture without implant removal. At 7.6 ± 0.5 years (range
6.8-9.3), the remaining 40 patients, aged 71.0 ± 8.5 years, achieved net
improvements of 40.7 ± 15.8 (CS), 62%±23% (age-/sex-adjusted CS), and
59.7 ± 16.4 (ASES). Of patients with complete absolute CS (n = 37) and ASES
score (n = 28), respectively, 33 (89%) and 27 (96%) achieved substantial
clinical benefits.
Conclusions
Stemless TSA yields improvements in functional outcomes at mid-term to
long-term that exceed the substantial clinical benefits of the absolute CS
and ASES score at a mean follow-up of 7.6 years. Although the findings of
this study revealed low complications and revision rates, more studies are
needed to confirm long-term benefits of stemless TSA.
Level of evidence
IV, case series.
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