Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty

Background The purpose was to report mid-term to long-term clinical outcomes in a multicentre series of patients who received stemless total shoulder arthroplasty (TSA). The hypothesis was that stemless TSA would be a safe and effective treatment with satisfactory clinical outcomes. Methods Authors...

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Main Authors: Thierry Authom MD, Tristan Lascar MD, Hassan Wahab MD, Antoine Gournay MD, Emmanuel Beaudouin MD, Jacobus H Muller PhD, Mo Saffarini M.Eng, MBA, FRSM, Geoffroy Nourissat MD
Format: Article
Language:English
Published: SAGE Publishing 2023-03-01
Series:Journal of Shoulder and Elbow Arthroplasty
Online Access:https://doi.org/10.1177/24715492231163055
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author Thierry Authom MD
Tristan Lascar MD
Hassan Wahab MD
Antoine Gournay MD
Emmanuel Beaudouin MD
Jacobus H Muller PhD
Mo Saffarini M.Eng, MBA, FRSM
Geoffroy Nourissat MD
author_facet Thierry Authom MD
Tristan Lascar MD
Hassan Wahab MD
Antoine Gournay MD
Emmanuel Beaudouin MD
Jacobus H Muller PhD
Mo Saffarini M.Eng, MBA, FRSM
Geoffroy Nourissat MD
author_sort Thierry Authom MD
collection DOAJ
description Background The purpose was to report mid-term to long-term clinical outcomes in a multicentre series of patients who received stemless total shoulder arthroplasty (TSA). The hypothesis was that stemless TSA would be a safe and effective treatment with satisfactory clinical outcomes. Methods Authors retrospectively reviewed records of 62 stemless TSAs implanted between March 2013 and December 2014. Six were excluded because they had fractures or muscular impairment, which left 56: primary osteoarthritis (n = 49), rheumatoid arthritis (n = 4), avascular necrosis (n = 1), or glenoid dysplasia (n = 2). Outcomes were absolute Constant Score (CS), age-/sex-adjusted CS, and the American Shoulder and Elbow Surgeons (ASES) score. Proportions of patients that achieved substantial clinical benefits for absolute CS and ASES scores were determined. Results Of the 56 patients, 8 (14%) died (unrelated to TSA), 5 (9%) were lost to follow-up, and 2 (4%) refused participation. One patient was reoperated for infection with implant removal (excluded from analysis), and one for periprosthetic fracture without implant removal. At 7.6 ± 0.5 years (range 6.8-9.3), the remaining 40 patients, aged 71.0 ± 8.5 years, achieved net improvements of 40.7 ± 15.8 (CS), 62%±23% (age-/sex-adjusted CS), and 59.7 ± 16.4 (ASES). Of patients with complete absolute CS (n = 37) and ASES score (n = 28), respectively, 33 (89%) and 27 (96%) achieved substantial clinical benefits. Conclusions Stemless TSA yields improvements in functional outcomes at mid-term to long-term that exceed the substantial clinical benefits of the absolute CS and ASES score at a mean follow-up of 7.6 years. Although the findings of this study revealed low complications and revision rates, more studies are needed to confirm long-term benefits of stemless TSA. Level of evidence IV, case series.
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spelling doaj.art-35c9f1323ff34e4b8f3b6a2cbd25933b2023-03-21T07:33:18ZengSAGE PublishingJournal of Shoulder and Elbow Arthroplasty2471-54922023-03-01710.1177/24715492231163055Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder ArthroplastyThierry Authom MD0Tristan Lascar MD1Hassan Wahab MD2Antoine Gournay MD3Emmanuel Beaudouin MD4Jacobus H Muller PhD5Mo Saffarini M.Eng, MBA, FRSM6Geoffroy Nourissat MD7 Clinique Saint Charles, Lyon, France Centre Hospitalier Princesse Grace, Monaco Clinique St Léonard, Trélazé, France Clinique St Léonard, Trélazé, France CHMS Chambery, Chambéry, France ReSurg S.A., Nyon, Switzerland ReSurg S.A., Nyon, Switzerland Clinique des Maussins, Ramsay Santé, Paris, FranceBackground The purpose was to report mid-term to long-term clinical outcomes in a multicentre series of patients who received stemless total shoulder arthroplasty (TSA). The hypothesis was that stemless TSA would be a safe and effective treatment with satisfactory clinical outcomes. Methods Authors retrospectively reviewed records of 62 stemless TSAs implanted between March 2013 and December 2014. Six were excluded because they had fractures or muscular impairment, which left 56: primary osteoarthritis (n = 49), rheumatoid arthritis (n = 4), avascular necrosis (n = 1), or glenoid dysplasia (n = 2). Outcomes were absolute Constant Score (CS), age-/sex-adjusted CS, and the American Shoulder and Elbow Surgeons (ASES) score. Proportions of patients that achieved substantial clinical benefits for absolute CS and ASES scores were determined. Results Of the 56 patients, 8 (14%) died (unrelated to TSA), 5 (9%) were lost to follow-up, and 2 (4%) refused participation. One patient was reoperated for infection with implant removal (excluded from analysis), and one for periprosthetic fracture without implant removal. At 7.6 ± 0.5 years (range 6.8-9.3), the remaining 40 patients, aged 71.0 ± 8.5 years, achieved net improvements of 40.7 ± 15.8 (CS), 62%±23% (age-/sex-adjusted CS), and 59.7 ± 16.4 (ASES). Of patients with complete absolute CS (n = 37) and ASES score (n = 28), respectively, 33 (89%) and 27 (96%) achieved substantial clinical benefits. Conclusions Stemless TSA yields improvements in functional outcomes at mid-term to long-term that exceed the substantial clinical benefits of the absolute CS and ASES score at a mean follow-up of 7.6 years. Although the findings of this study revealed low complications and revision rates, more studies are needed to confirm long-term benefits of stemless TSA. Level of evidence IV, case series.https://doi.org/10.1177/24715492231163055
spellingShingle Thierry Authom MD
Tristan Lascar MD
Hassan Wahab MD
Antoine Gournay MD
Emmanuel Beaudouin MD
Jacobus H Muller PhD
Mo Saffarini M.Eng, MBA, FRSM
Geoffroy Nourissat MD
Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty
Journal of Shoulder and Elbow Arthroplasty
title Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty
title_full Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty
title_fullStr Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty
title_full_unstemmed Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty
title_short Mid-Term to Long-Term Follow-Up of Stemless Anatomic Total Shoulder Arthroplasty
title_sort mid term to long term follow up of stemless anatomic total shoulder arthroplasty
url https://doi.org/10.1177/24715492231163055
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