ArticlePloS one2022
Using standard-length compactors to implant short humeral stems in total shoulder arthroplasty: A cadaver study of humeral stem alignment.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Standard-length stems require lower distal filling ratios than short stems to achieve neutral alignment in reverse total shoulder arthroplasty.JSES international · 2026Article
- Recent Advances in the Design and Application of Shoulder Arthroplasty Implant Systems and Their Impact on Clinical Outcomes: A Comprehensive Review.Orthopedic research and reviews · 2024Review
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShort-stem implants in shoulder arthroplasty were recently developed and reported clinical outcomes are good. However, radiological analysis often reveals humeral stem misalignment in the frontal plane, along with high filling ratios that can lead to proximal bone remodeling under stress shielding. The aim of this cadaveric study was to test whether using compactors for standard-length (> 100 mm) stems to implant short (< 100 mm) stems reduces the risk of stem misalignment without compromising in terms of a higher filling ratio.
methodsIn a cadaveric study, twenty short stems were implanted using instrumentation for standard-length stems. Alignment and filling ratios were evaluated on anteroposterior radiographs for both the compactors and the stems. The angular deviations (α) from the humeral axis of the compactors and the short stems were measured. Misalignment was defined as |α| > 5°. Metaphyseal and diaphyseal filling ratios were calculated and defined as either high (≥ 0.7) or low (< 0.7).
resultsThe median angular deviations of the compactors and the short stems were respectively 1.6° (range, 0.03 to 5.9°) and 1.3° (range, 0.3 to 9.6°). Nineteen of the 20 compactors (95%) and 17/20 short stems (85%) were correctly aligned. The proportions of correctly aligned compactors and stems were not significantly different (95% CI, -0.33 to 0.11; Z-test of proportions p = .60), and the respective angular deviations were significantly correlated (Spearman ρ = .60, p = 0.006). The diaphyseal and metaphyseal filling ratios of the compactors and the stems were all low.
conclusionsIn this series of 20 implants in cadavers, the narrow short humeral stems implanted with compactors for standard-length stems were correctly aligned with the humeral axis. This approach may be a way to achieve both correct frontal alignment and low filling ratios.
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