ArticleSICOT-J2024
Stress shielding in stemmed reverse shoulder arthroplasty: an updated review.
Article in SICOT-J, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Radiographic assessment of reverse shoulder arthroplasty: a narrative review of post-operative parameters and measurements.JSES reviews, reports, and techniques · 2026Review
- Radiographic bone resorption after reverse total shoulder arthroplasty using a single onlay platform: risk factors and distribution patterns in a Japanese cohort.Journal of shoulder and elbow arthroplasty · 2026Article
- Long-Term Outcomes of Inverted-Bearing Reverse Shoulder Arthroplasty with Large Polyethylene Glenospheres.Journal of clinical medicine · 2026Article
- Osteoporosis and osteoporosis therapies as determinants of implant fixation failure in arthroplasty and spinal fusion constructs: a position statement from the Fracture Working Group of the Council of Scientific Advisors of the International Osteoporosis Foundation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Incidence of radiographic humeral bone remodeling after reverse total shoulder arthroplasty and its impact on clinical outcome.Journal of shoulder and elbow arthroplasty · 2026Article
- Accuracy of implant placement after preoperative planning using Blueprint software in inlay and onlay reverse total shoulder arthroplasty systems: a cadaver study.Journal of shoulder and elbow surgery · 2026Article
- Factors Influencing Stem Subsidence in 135-Degree Inlay Reverse Shoulder Arthroplasty.Journal of clinical medicine · 2025Article
- Does stem length affect proximal humeral stress shielding? A systematic review.Journal of orthopaedics · 2025Review
- Mechanobiological evaluation of solid and multiple porous humeral stem architectures in reverse shoulder arthroplasty based on design and materials: a finite element study.Frontiers in bioengineering and biotechnology · 2025Article
- Greater Tuberosity Healing Rate and Clinical Results Following RSA Are Similar for Two Fracture-Specific Implant Systems.Journal of clinical medicine · 2024Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReverse shoulder arthroplasty (RSA) is popular for the treatment of degenerative glenohumeral joint disease. Bone remodeling around the humeral stem related to stress shielding (SS) has been described. This review focuses on the specific radiological characteristics, risk factors, and clinical consequences of SS in RSA.
methodsA meticulous review was conducted of articles published between 2013 and 2023. Data on the definition, risk factors, and clinical impact of stress shielding were recorded.
resultsTwenty-eight studies describing 2691 patients who had undergone RSA were included. The mean age of patients ranged from 63 to 80 years with mean follow-up periods of 12 months to 9.6 years. The prevalence of SS reached up to 39% at a 2-year follow-up. Females and elderly are typically at higher risk due to osteopenia. SS was more frequent with the use of long stems(>100 mm) compared to short stems(<100 mm). Stem design, onlay or inlay, and neck-shaft-angle did not influence SS. Frontal misalignment and a high filling ratio are riskfactors for SS. Biological factors also contribute to SS, associated with scapular notching. No correlation was found between SS and clinical outcomes.
conclusionsSS is common in patients with cementless implants after RSA, especially in female and elderly patients. It can be limited by implanting stems with a low diaphyseal filling-ratio, in correct coronal alignment. Risk factors for polyethylene debris, primarily scapular notching, should be avoided. The authors found no clinical consequences of stress shielding, but longer-term follow-up studies are required to confirm these findings.
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