These authors reviewed their experience with 105 shoulders treated with the Sidus Stem-Free Shoulder System at 9 centers in Europe at 2 or more years after surgery.
The main indication was primary osteoarthritis (80.1%). Total shoulder arthroplasty was performed in 73 cases and hemiarthroplasty in 32. Clinical scores were improved. Radiologically, neither migration nor loosening was found. However, radiolucent lines of 2 mm or greater could be detected around the glenoid in 2 cases, but none of them have had clinical relevance yet. The overall complication rate was 6.7%, and the revision rate was 0%.
The authors concluded that patients receiving the Sidus Stem-Free Shoulder System achieve good clinical and radiologic short term results that are comparable with the results of other stem-free shoulder implants.
Comment: The motivation for pursuing 'stemless' humeral components apparently comes from concern about "stem-related complications", including intraoperative humeral fracture, postoperative periprosthetic humeral fracture, proximal humeral bone loss due to stress shielding, humeral stem loosening, osteolysis, and difficulty in explanting a well-fixed stem in the case of revision.
The complication rate with this stemless implant was 6.7% including one humeral fracture. There was a 9.5% rate of radiolucent lines around the glenoid components. In their review of the literature on stemless implants, these authors point out revision rates for stemless shoulder arthroplasties ranging from 2 to 11% and relatively high rates of glenoid radiolucent lines.
An important perspective can be gained by comparing theses complication and revision rates to those from a recent review of complications for shoulder arthroplasty (see this link) which found that humeral complications in shoulder arthroplasty were relatively uncommon: " Humeral component failure occurred in 47 shoulders, for a prevalence of 0.2%. Stem loosening appeared to be dependent on the glenoid implant status in TSA, rather than the mode of humeral stem fixation."
"Periprosthetic humeral and glenoid fractures demonstrated a prevalence of 1.0%"
The data in this paper do not provide evidence that a stemless humeral implant is superior to an impaction grafted thin stem (see this link), which avoids each of the "stem-related complications" listed above using a conventional implant that is applicable to most shoulders without limitations related to bone quality:
An important perspective can be gained by comparing theses complication and revision rates to those from a recent review of complications for shoulder arthroplasty (see this link) which found that humeral complications in shoulder arthroplasty were relatively uncommon: " Humeral component failure occurred in 47 shoulders, for a prevalence of 0.2%. Stem loosening appeared to be dependent on the glenoid implant status in TSA, rather than the mode of humeral stem fixation."
"Periprosthetic humeral and glenoid fractures demonstrated a prevalence of 1.0%"
The data in this paper do not provide evidence that a stemless humeral implant is superior to an impaction grafted thin stem (see this link), which avoids each of the "stem-related complications" listed above using a conventional implant that is applicable to most shoulders without limitations related to bone quality:
=====
Use the "Search" box to the right to find other topics of interest to you.
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 including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
