Prospective, Blinded, Randomized Controlled Trial of Stemless Versus Stemmed Humeral Components in Anatomic Total Shoulder Arthroplasty: Results at Short-Term Follow-up.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(5):11 J Bone Joint Surg Am. 2020 Nov 18;102(22):1974-1984.What this means for my practice?
Stemless humeral implants are a viable alternative to stemmed implants in aTSA, providing similar functional outcomes, complication rates, and radiographic findings over a 2-year period. Clinically, these findings support the use of stemless implants for patients who meet the criteria for their use. However, the study is limited by its short follow-up duration, and longer-term data are needed to confirm the sustained benefits and durability of stemless implants.
Study Summary
Two hundred sixty-five patients with osteoarthritis were randomized to receive either a stemless humeral implant (n=133) or a stemmed humeral implant (n=132) in anatomic total shoulder arthroplasty (aTSA). The primary outcomes were the American Shoulder and Elbow Surgeons (ASES) score at 2 years, the absence of device-related complications, and the absence of radiographic loosening. Secondary outcomes included range of motion, Single Assessment Numeric Evaluation (SANE) scores, and Constant scores, assessed at multiple time points over 2 years. Overall, the study found that the stemless implant was noninferior to the stemmed implant in all primary outcomes, with no significant differences in secondary outcomes between groups. These findings suggest that stemless implants provide comparable short-term safety and effectiveness to stemmed implants in aTSA.
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