Stemless anatomic TSA result ed in similar functional outcomes and complication rates to stemmed TSA with decreased operative time and lower blood loss .
BACKGROUND Stemless anatomic total shoulder arthroplasty ( TSA ) is used in the treatment of osteoarthritis of the shoulder joint and other degenerative shoulder diseases .
It has several proposed advantages over stemmed TSA including increased bone preservation , decreased operative time , and easier removal at revision .
Clinical and Radiographic Outcomes of the Simpliciti Canal-Sparing Shoulder Arthroplasty System: A Prospective Two-Year Multicenter Study.
BACKGROUND Stemmed humeral components have been used since the 1950s ; canal-sparing ( also known as stemless ) humeral components became commercially available in Europe in 2004 . The Simpliciti total shoulder system ( Wright Medical , formerly Tornier ) is a press-fit , porous-coated , canal-sparing humeral implant that relies on metaphyseal fixation only . This prospect i ve , single-arm , multicenter study was performed to evaluate the two-year clinical and radiographic results of the Simpliciti prosthesis in the U.S. METHODS One hundred and fifty-seven patients with glenohumeral arthritis were enrolled at fourteen U.S. sites between July 2011 and November 2012 in a U.S. Food and Drug Administration ( FDA ) Investigational Device Exemption (IDE)-approved protocol . Their range of motion , strength , pain level , Constant score , Simple Shoulder Test ( SST ) score , and American Shoulder and Elbow Surgeons ( ASES ) score were compared between the preoperative and two-year postoperative evaluations . Statistical analyses were performed with the Student t test with 95 % confidence intervals . Radiographic evaluation was performed at two weeks and one and two years postoperatively . RESULTS One hundred and forty-nine of the 157 patients were followed for a minimum of two years . The mean age and sex-adjusted Constant , SST , and ASES scores improved from 56 % preoperatively to 104 % at two years ( p < 0.0001 ) , from 4 points preoperatively to 11 points at two years ( p < 0.0001 ) , and from 38 points preoperatively to 92 points at two years ( p < 0.0001 ) , respectively . The mean forward elevation improved from 103 ° ± 27 ° to 147 ° ± 24 ° ( p < 0.0001 ) and the mean external rotation , from 31 ° ± 20 ° to 56 ° ± 15 ° ( p < 0.0001 ) . The mean strength in elevation , as recorded with a dynamometer , improved from 12.5 to 15.7 lb ( 5.7 to 7.1 kg ) ( p < 0.0001 ) , and the mean pain level , as measured with a visual analog scale , decreased from 5.9 to 0.5 ( p < 0.0001 ) . There were three postoperative complications that result ed in revision surgery : infection , glenoid component loosening , and failure of a subscapularis repair . There was no evidence of migration , subsidence , osteolysis , or loosening of the humeral components or surviving glenoid components . CONCLUSIONS The study demonstrated good results at a minimum of two years following use of the Simpliciti canal-sparing humeral component . Clinical results including the range of motion and the Constant , SST , and ASES scores improved significantly , and radiographic analysis showed no signs of loosening , osteolysis , or subsidence of the humeral components or surviving glenoid components . LEVEL OF EVIDENCE Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence
Stemless anatomic TSA result ed in similar functional outcomes and complication rates to stemmed TSA with decreased operative time and lower blood loss .
BACKGROUND Stemless anatomic total shoulder arthroplasty ( TSA ) is used in the treatment of osteoarthritis of the shoulder joint and other degenerative shoulder diseases .
It has several proposed advantages over stemmed TSA including increased bone preservation , decreased operative time , and easier removal at revision .