BACKGROUND:
Several stemless shoulder implants are available on the market, but only a few studies have presented results with sufficient mid- to long-term follow-up. The present study evaluated clinical and radiologic outcomes 9 years after anatomic stemless shoulder replacement.

METHODS:
This is a prospective cohort study evaluating the stemless shoulder prosthesis since 2005. Anatomic stemless shoulder replacement using a single prosthesis was performed in 49 shoulders; 17 underwent total shoulder replacement, and 32 underwent hemiarthroplasty. Forty-three patients were clinically and radiologically monitored after a mean of 9 years (range, 90-127 months; follow-up rate, 88%). The indications for shoulder replacement were primary osteoarthritis in 7 shoulders, post-traumatic in 24, instability in 7, cuff tear arthropathy in 2, postinfectious arthritis in 1, and revision arthroplasty in 2.

RESULTS:
The Constant-Murley Score improved significantly from 52% to 79% (P <  .0001). The active range of motion also increased significantly for flexion from 101° to 118° (P = .022), for abduction from 79° to 105° (P = .02), and for external rotation from 21° to 43° (P <  .0001). Radiologic evaluation revealed incomplete radiolucency in 1 patient without clinical significance or further intervention. No revision caused by loosening or countersinking of the humeral implant was observed.

CONCLUSIONS:
The 9-year outcome after stemless shoulder replacement is comparable to that of third- and fourth-generation standard shoulder arthroplasty.



Polls results
1

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
100% Article relates to my practice (5/5)
0% Article does not relate to my practice (0/5)
0% Undecided (0/5)
2

Will this article lead to more cost-effective healthcare?

60% Yes (3/5)
40% No (2/5)
0% Undecided (0/5)
3

Was this article biased? (commercial or personal)

0% Yes (0/5)
100% No (5/5)
0% Undecided (0/5)
4

What level of evidence do you think this article is?

0% Level 1 (0/5)
0% Level 2 (0/5)
60% Level 3 (3/5)
40% Level 4 (2/5)
0% Level 5 (0/5)