Short Stems and Stemless Shoulder Arthroplasty: Current Concepts Review

Document Type : CURRENT CONCEPTS REVIEW

Authors

1 1 Hospital General de Granollers, Avinguda Francesc Ribas s/n, postcode: 08402, Granollers, Barcelona, Spain 2 Universitat Autònoma de Barcelona, Campus Bellaterra, Cerdanyola del Vallès, Barcelona, Spain

2 Reading Shoulder Unit, Berkshire Independent Hospital, Reading, United Kingdom

3 Hospital General de Granollers, Avinguda Francesc Ribas s/n, postcode: 08402, Granollers, Barcelona, Spain

Abstract

Historically, the shoulder arthroplasty humeral component has been designed for the management of infections, 
tumours and fractures. In all these cases the stem was needed as a scaffold. Original humeral components were not 
developed for use in shoulder arthritis, so these designs and derivates had a long stem. The newest humeral implants 
innovations consist in shortening of the implant, or even removing the whole stem, to rely on stemless fixation at the 
level of the metaphysis. This implies the advantages of preserved bone stock, less stress shielding, eliminating the 
diaphyseal stress riser, easier implant removal at revision, and humeral component placement independent from the 
humeral diaphyseal axis. Nowadays, surgeons try to balance the need for a stable fixation of the humeral component 
with the potential need for revision surgery. Complications of revision shoulder arthroplasty are related to the need for 
removing a well-fixed humeral stem, the length of the procedure, and the need to treat severe bone loss. 
Level of evidence: V

Keywords

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The Archives of Bone and Joint Surgery
Volume 10, Issue 8
August 2022
Pages 633-647

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History

  • Receive Date: 02 December 2020
  • Revise Date: 01 March 2021
  • Accept Date: 04 March 2021
  • First Publish Date: 03 April 2021

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