Stemless shoulder replacement: a new concept for shoulder arthritis

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Stemless shoulder arthroplasty implants allow a surgeon to more accurately recreate a patient’s normal anatomy because the implant is contained solely within the proximal humeral metaphysis. As well, this has the potential to avoid humeral stem-related complications, such as intraoperative fracture, periprosthetic fracture, and difficulties with revisions and stem extraction. Canal sparing shoulder arthroplasty implants have been used since 2004, and currently six manufacturers have designs available. Short-term to mid-term results are promising, with low rates of loosening and revision, similar to stemmed implants. However, long-term outcomes are not yet available. Stemless reverse shoulder arthroplasty offers the same potential benefits as anatomic stemless designs. Some implants are a convertible design that allows conversion from an anatomic to a reverse humeral component while leaving the metaphyseal implant in place. Short-term to mid-term outcomes are available only for one implant and are promising. Long-term outcomes of stemless reverse shoulder implants are not known.

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