Results of a new stemless shoulder prosthesis: Radiologic proof of maintained fixation and stability after a minimum of three years' follow-up

Hypothesis In total shoulder arthroplasty, the humeral component, particularly the stem, can be involved in some of the complications and technical difficulties increase in posttraumatic arthritis with proximal humeral malunion. To decrease the intraoperative complications related to the stem, the T...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2010-09, Vol.19 (6), p.847-852
Main Authors: Huguet, Dominique, MD, DeClercq, Geert, MD, Rio, Bruno, MD, Teissier, Jacques, MD, Zipoli, Bruno, MD
Format: Article
Language:English
Subjects:
Aged
Arthrography
Arthroplasty, Replacement - instrumentation
Biological and medical sciences
Diseases of the osteoarticular system
Female
Follow-Up Studies
Humans
Male
Medical sciences
Middle Aged
Orthopedic surgery
Orthopedics
Osteoarthritis - diagnostic imaging
Osteoarthritis - physiopathology
Osteoarthritis - surgery
Prosthesis Design
Range of Motion, Articular
resurfacing cap
Retrospective Studies
shoulder arthroplasty
Shoulder Joint - diagnostic imaging
Shoulder Joint - physiopathology
Shoulder Joint - surgery
Stemless shoulder arthroplasty
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surveys and Questionnaires
Time Factors
Treatment Outcome
tuberosity malunion
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Summary:Hypothesis In total shoulder arthroplasty, the humeral component, particularly the stem, can be involved in some of the complications and technical difficulties increase in posttraumatic arthritis with proximal humeral malunion. To decrease the intraoperative complications related to the stem, the TESS (Biomet Inc, Warsaw, IN) humeral implant, was designed in 2004 hypothesis that we can obtain a good fixation with a stemless prothesis. This investigation reports the preliminary results of this prosthesis with more than 3 years of follow-up. Methods Between March 2004 and June 2005, 70 patients underwent 72 shoulder replacements with the TESS humeral prosthesis. Sixty-three patients were reviewed with a follow-up of more than 36 months (average, 45.2 months; range, 36-51 months). The mean preoperative Constant score was 29.6. Results Gain in active mobility was 49° for forward flexion and 20° for external rotation. The postoperative Constant score was 75. Radiographic analysis showed no radiolucencies or implant migration. Functional results are comparable with previous reports on prosthetic glenohumeral replacement. Discussion Our clinical results are similar to this with classical prosthesis. The humeral head removal facilitates the glenoid exposure and implantation. After the initial cases any specific complication was seen. Conclusions Owing to the automatic central positioning of the implant, an anatomic reconstruction was achieved. In malunions, no tuberosity osteotomy was required. At 3 years of follow-up, there is radiologic evidence of maintained implant stability. These encouraging preliminary results confirm our belief that a stemless prosthesis can be used to obtain an anatomic reconstruction of the proximal humerus. A longer-term follow-up study is needed to validate these results.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2009.12.009