Stemless, short and standard humeral stems in total shoulder arthroplasty: is there a difference in intraoperative measures, pain, and outcomes in the short term?

As anatomic total shoulder arthroplasty (aTSA) has evolved, surgeons are utilizing stemless and short-stem humeral implants with increasing frequency. Bone preservation, decreased blood loss, decreased surgical time, decreased pain, and improved outcomes have been described as theoretical advantages...

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Bibliographic Details
Published in:Seminars in arthroplasty 2023-03, Vol.33 (1), p.200-206
Main Authors: Labrum, Joseph T., Routman, Howard D., Friedman, Richard J., Roche, Christopher P., Byram, Ian R.
Format: Article
Language:English
Subjects:
Arthroplasty
Blood loss
Humeral
Pain
Shoulder
Stem
Stemless
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Summary:As anatomic total shoulder arthroplasty (aTSA) has evolved, surgeons are utilizing stemless and short-stem humeral implants with increasing frequency. Bone preservation, decreased blood loss, decreased surgical time, decreased pain, and improved outcomes have been described as theoretical advantages for shorter stem and stemless implants. Comparisons of outcomes between different length humeral stems that control for manufacturer and model of humeral and glenoid implants are currently limited. The purpose of this study is to determine if differences exist in the short-term outcomes between stemless, short-stem (SS), and traditional-length (TL) humeral stems in aTSA. A multicenter international shoulder arthroplasty database utilizing a single implant system was retrospectively analyzed to compare intraoperative and short-term outcomes between stemless, SS, and TL humeral stem implants. Intraoperative measures including surgical time and estimated blood loss were recorded. Postoperative outcomes including improvements in multiple pain measures, Global Shoulder Function Score, Simple Shoulder Test, University of California at Los Angeles, American Shoulder and Elbow Surgeons, and Shoulder Pain and Disability Index scores were compared between the three cohorts at 0-3 months, 3-6 months, 6-12 months, and 1-2 years postoperatively. Statistical analysis was performed using a Student’s unpaired two-tailed t-test to quantify differences in means between cohorts with a P value  .05). Estimated blood loss was significantly higher in TL (avg 214 cc) when compared to SS (avg 165 cc, P 
ISSN:1045-4527
1558-4437
DOI:10.1053/j.sart.2022.10.004