ArticleInternational orthopaedics2022
Humeral stem with low filling ratio reduces stress shielding in primary reverse shoulder arthroplasty.
Article in International orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Radiological and Clinical Outcome Differences Between Standard and Short Stem in Reverse Total Shoulder Arthroplasty: A Systematic Review.Medical sciences (Basel, Switzerland) · 2025Pooled it
- Incidence of radiographic humeral bone remodeling after reverse total shoulder arthroplasty and its impact on clinical outcome.Journal of shoulder and elbow arthroplasty · 2026Article
- Clinical and radiological outcomes of Inlay versus Onlay humeral stems in reverse shoulder arthroplasty with a 145° neck shaft angle: a multicentre retrospective study with a minimum follow-up of three years, an analysis from the registry of the shoulder friends institute.International orthopaedics · 2026Article
- Volumetric 3-dimensional computed tomography analysis of proximal humeral bone resorption after reverse total shoulder arthroplasty.Journal of orthopaedic surgery and research · 2026Article
- Clinical relevance, classification, and risk factors for stress shielding in total shoulder arthroplasty: a systematic review and meta-analysis of clinical outcomes.EFORT open reviews · 2026Review
- Evaluation of spin in the abstracts of systematic reviews and meta-analyses of stemless total shoulder arthroplasty.JSES reviews, reports, and techniques · 2025Review
- Factors Influencing Stem Subsidence in 135-Degree Inlay Reverse Shoulder Arthroplasty.Journal of clinical medicine · 2025Article
- Uncemented vs. cemented reverse total shoulder arthroplasty with latissimus dorsi and teres major transfer.JSES international · 2025Article
- Does stem length affect proximal humeral stress shielding? A systematic review.Journal of orthopaedics · 2025Review
- Surgical Outcomes of Weight-Bearing Shoulders: Arthroscopic Rotator Cuff Repair and Reverse Shoulder Arthroplasty.Clinics in orthopedic surgery · 2025Article
- Uncemented reverse total shoulder arthroplasty: is it a safe option for elderly patients with proximal humerus fractures?International orthopaedics · 2025Article
- Reverse shoulder arthroplasty for two-parts proximal humerus fractures with "shish-kebab" technique.JSES reviews, reports, and techniques · 2024Article
- Finite element analysis part 1 of 2: Influence of short stem implant polyethylene configuration on glenohumeral joint biomechanics.Journal of experimental orthopaedics · 2024Article
- Stress shielding: short-term radiological results of the reverse shoulder arthroplasty with an anatomic proximal coated stem in proximal humeral fractures.Archives of orthopaedic and trauma surgery · 2024Article
- The effects of length and width of the stem on proximal humerus stress shielding in uncemented primary reverse total shoulder arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
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Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSome patients show severe humeral bone stress shielding even one year after press-fit humeral stem, which can be a risk factor for implant durability. This study compared humeral stress shielding and clinical outcomes between high and low filling ratio (HFR and LFR) stems in primary reverse shoulder arthroplasty (RSA).
methodsFrom 2015 to 2020, 104 patients who underwent RSA with a non-cemented standard-length humeral stem were examined. The humeral stems included large press-fit stems (HFR group, 53 patients) or small non-press-fit stems with autogenous cancellous bone grafting (LFR group, 51 patients). The radiologic and clinical outcomes were compared between the groups one year post-operatively.
resultsOne patient in the LFR group with early infectious dislocation was excluded from the 1-one year evaluation. No stress shielding was observed in 27/50 (54.0%) and 5/53 (9.4%) of patients in the LFR and HFR groups, while 3/50 (6%) and 19/53 (35.8%) patients showed high-stress shielding, respectively. However, the stem alignment change, subsidence, complications and evidence of loosening did not differ between the groups. The final range-of-motion and functional scores were significantly poorer in the LFR group than those in the HFR group, although the difference was minimal.
conclusionEven at one year follow-up, patients receiving LFR stems with autogenous bone grafting had significantly less humeral stress shielding compared to patients with HFR stem with press-fit in primary RSA, without compromising stem stability.
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