Stemless shoulder arthroplasty: current status

• Published in: Journal of shoulder and elbow surgery Vol. 23; no. 9; pp. 1409 - 1414
• Main Author: Churchill, R. Sean, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.09.2014
• Subjects: arthritis; Arthroplasty, Replacement - instrumentation; Humans; Humerus - surgery; Joint Prosthesis; Orthopedics; Prosthesis Design; shoulder arthritis; Shoulder arthroplasty; Shoulder Joint - surgery; stemless arthroplasty; total shoulder arthroplasty; United States; United States; shoulder arthritis; Shoulder arthroplasty; arthritis; Review Article; stemless arthroplasty; total shoulder arthroplasty
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2014.05.005

Background Since the original Neer humeral replacement in the 1950s, the standard primary anatomic total shoulder arthroplasty design has slowly evolved. Most recently, the humeral stem has become progressively shorter to help combat stem-related complications. Currently, there are several companies who have developed and marketed a stemless humeral arthroplasty component. Materials and methods Manufacturers' data for 5 stemless shoulder arthroplasty components currently on the market were analyzed and reviewed. A literature review of short-term results for stemless shoulder arthroplasty was completed. Results Of the stemless shoulder arthroplasty systems available on the market, 3 are currently undergoing clinical trials in the United States. The Tornier Simpliciti (Tornier, Edina, MN, USA) clinical trial began in 2011. The study with 2-year minimum follow-up results is scheduled for completion in November 2014. The Arthrex Eclipse (Arthrex, Naples, FL, USA) clinical trial was started in January 2013. The tentative study completion date is 2017. The Biomet Nano (Biomet, Warsaw, IN, USA) clinical trial began in October 2013 and also has a tentative completion date of 2017. No other clinical trial is currently under way in the United States. Early results for stemless shoulder arthroplasty indicate clinical results similar to standard stemmed shoulder arthroplasty. Radiographic analysis indicates implant stability without migration or subsidence at 2- to 3-year minimum follow-up.. Conclusions Several stemless shoulder arthroplasty implants are available outside the United States. Early clinical and radiographic results are promising, but well-designed clinical studies and midterm results are lacking. Three clinical trials are currently under way in the United States with initial availability for use anticipated in 2015.