Stemless shoulder arthroplasty: a literature review

Abstract

The design of humeral implants for shoulder arthroplasty has evolved over the years. The new-generation modular shoulder prostheses have an anatomical humeral stem that replicates the three-dimensional parameters of the proximal humerus. An anatomical reconstruction is the best way to restore stability and mobility of the prosthetic shoulder and improve implant durability. However, a perfect anatomical match is not always possible in, for example, patients with post-traumatic osteoarthritis of the shoulder and deformities in the metaphyseal region. To avoid stem-related complications while retaining the advantages of the fourth generation of shoulder implants, different stemless implants have been developed. The stemless shoulder prosthesis is a new concept in shoulder arthroplasty. The authors review the indications, surgical technique, clinical and radiological midterm results, and complications of these humeral implants.

Keywords: arthroplasty; osteoarthritis; post-traumatic; shoulder; stemless.

Fig. 1

Preoperative AP radiograph of a 67-year-old woman showing concentric degenerative arthritis.

Fig. 2

A: Intraoperative photograph of the metaphyseal corolla (Total Evolutive Shoulder System, Biomet) in place showing complete seating of the component with considerable bone preservation. B: AP radiograph, three years postoperatively, showing the implant matching the patient’s anatomy and the humeral head centered on the prosthetic glenoid.