Total shoulder arthroplasty - is a stemless humeral component a better value?

By: [email protected] (Frederick A. Matsen III, M.D.)

Posted on: December 10, 2020

Total shoulder arthroplasty - is a stemless humeral component a better value?

 Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference?

These authors note that there is a recent trend toward the use of shorter stems in total shoulder arthroplasty. They examined the relationship between humeral component stem length and the restoration of native humeral head anatomy in a retrospective review of 261 patients who underwent total shoulder arthroplasty for primary osteoarthritis.

Preoperative and postoperative radiographic measurements of the center of rotation (COR), humeral head height (HH), and neck-shaft angle were performed. Restoration of the native humeral anatomy was deemed ‘‘acceptable’’ based on postoperative differences in the COR 3 mm, HH 5 mm, and neck-shaft angle > 130. 

They found that stemless arthroplasty implants were more likely to be placed in varus (22.6%) compared with short-stem (7.0%) and standard-stem (3.7%) designs.

They concluded that the stem of a shoulder arthroplasty implant aids surgeons in accurately restoring patient-specific anatomy.

Unfortunately, this study did not compare the clinical outcomes among the different humeral component designs.

Comment: Some surgeons are advocates of "humeral shrinkage". 

Our approach to total shoulder arthroplasty can be viewed by clicking here.

To support our research to improve outcomes for patients with shoulder problems, click here.

To subscribe to this blog, enter your email in the box to your right that looks like the below

===
How you can support research in shoulder surgery Click on this link.

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages  arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'