ArticleJSES international2025
Two-year functional and radiographic outcomes of a convertible metaphyseal-based short humeral stem in anatomic shoulder arthroplasty: a comparison to stemless humeral components.
Article in JSES international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The purpose of this study was to compare the restoration of humeral head anatomy, as well as 2-year radiographic and functional outcomes of anatomic total shoulder arthroplasty (aTSA) using a convertible metaphyseal-based short inlay humeral stem and a stemless humeral component. Methods: All patients between May 2021 and May 2022 that underwent aTSA using a convertible metaphyseal-based short inlay humeral stem by a single surgeon were included and compared to a cohort of patients that underwent stemless aTSA by the same surgeon between February 2019 and October 2020. An intramedullary cutting guide, a large lesser tuberosity osteotomy (LTO) repaired with cerclage wires, and preoperative 3-dimensional planning were utilized in all cases. The restoration of humeral head anatomy was assessed on an AP radiograph of the proximal humerus 2 weeks postoperatively. Functional outcome scores, range of motion, and LTO healing were collected 2-years postoperatively. Calcar stress shielding was assessed on 2-year postoperative radiographs using the Levy classification. Results: Overall, there were 26 patients (81.3% follow-up) in the stem group and 43 patients (84.3% follow-up) in the stemless group with 2-year follow-up data. All patients (32 stem/51 stemless) were included in the radiographic analysis assessing humeral head restoration. There were no differences in the humeral head height change ( Conclusions: Anatomic shoulder arthroplasty with a convertible metaphyseal-based short inlay humeral stem demonstrates excellent patient-reported functional and radiographic outcomes 2 years postoperatively. No differences in restoration of humeral head anatomy, degree of stress shielding, patient-reported functional outcomes, and osteotomy healing rates were identified between patients undergoing metaphyseal short-stemmed and stemless aTSA.
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