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      Functional midterm follow-up comparison of stemless total shoulder prostheses versus conventional stemmed anatomic shoulder prostheses using a 3D-motion-analysis

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          Abstract

          Background

          The aim of this study is to compare the functional midterm outcome of stemless shoulder prostheses with standard anatomical stemmed shoulder prostheses and to show that the STEMLESS results are comparable to the STEMMED with respect to active maximum range of shoulder motion (ROM) and Constant score (CS).

          Methods

          Seventeen patients underwent total shoulder arthroplasty (TSA) in 25 shoulder joints. Stemless TSA was performed in 12 shoulder joints (group STEMLESS), third-generation stemmed TSA in 13 shoulder joints (group STEMMED). Functional results were documented using the CS. 3D-motion-analysis using the Heidelberg upper extremity model (HUX) was conducted to measure active maximum (ROM).

          Results

          The group STEMLESS achieved a CS of 67.9 (SD 12.0) points and the group STEMMED of 70.2 (SD 5.8 points) without significant difference between the groups ( p = 0.925). The maximum ROM of the group STEMLESS, ascertained by 3-D-motion-analysis, was in forward flexion 125.5° (SD 17.2°), in extension 49.4° (SD 13.8°), in abduction 126.2° (SD 28.5°) and in external rotation 40.3° (SD 13.9°). The maximum ROM of the group STEMMED, also ascertained by 3-D-motion analysis, was in forward flexion 135.0° (SD 16.8°), in extension 47.2° (SD 11.5°), in abduction 136.3° (SD 24.2°) and in external rotation 40.1° (SD 12.2°). The maximum ROM of the STEMLESS group was lower in forward flexion and abduction, higher in extension and almost identical in external rotation. But there was no significant difference (forward flexion p = 0.174, extension p = 0.470, abduction p = 0.345, external rotation p = 0.978).

          Conclusion

          Both types of shoulder prostheses achieve a similar and good active ROM and similar results in CS.

          Trial registration

          DRKS00013166, retrospectively registered, 11.10.2017

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          Most cited references21

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          A review of the Constant score: modifications and guidelines for its use.

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            Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis

            Background The stemless shoulder prosthesis is a new concept in shoulder arthroplasty. To date, only a few studies have investigated the results of this prosthesis. The aim of this study was to investigate the clinical and radiological midterm results of this implant in comparison with a standard anatomic stemmed shoulder prosthesis. Materials and methods The Constant score, the DASH score, the active range of motion (abduction, anteversion, external rotation), and the radiological results were examined in 82 patients with primary osteoarthritis of the shoulder treated with either the Total Evolutive Shoulder System® (Biomed, France) stemless shoulder prosthesis or the Affinis® (Mathys, Switzerland) stemmed shoulder prosthesis to detect possible differences in the functional outcome and to evaluate radiological properties of the implants. Patients were examined before and 32 ± 4 months after surgery. Results There was no significant difference in the Constant scores of the groups treated with the stemless shoulder prosthesis (65.0 ± 11.0 points) and the stemmed shoulder prosthesis (73.2 ± 11.3 points; P = 0.162). The estimated blood loss (P = 0.026) and the mean operative time (P = 0.002) were significantly lower in the group with the stemless shoulder prosthesis. Conclusions The use of the stemless shoulder prosthesis yielded good results which, in a mid-term follow-up, were comparable with those provided by a standard anatomic shoulder prosthesis. Further investigations are needed regarding the long-term performance of this prosthesis.
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              Results of a new stemless shoulder prosthesis: radiologic proof of maintained fixation and stability after a minimum of three years' follow-up.

              In total shoulder arthroplasty, the humeral component, particularly the stem, can be involved in some of the complications and technical difficulties increase in posttraumatic arthritis with proximal humeral malunion. To decrease the intraoperative complications related to the stem, the TESS (Biomet Inc, Warsaw, IN) humeral implant, was designed in 2004 hypothesis that we can obtain a good fixation with a stemless prosthesis. This investigation reports the preliminary results of this prosthesis with more than 3 years of follow-up.
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                Author and article information

                Contributors
                David.Spranz@med.uni-heidelberg.de
                Hendrik.Bruttel@gmail.com
                Sebastian.Wolf@med.uni-heidelberg.de
                Felix.Zeifang@med.uni-heidelberg.de
                +49-6221-56 25000 , Michael.Maier@med.uni-heidelberg.de
                Journal
                BMC Musculoskelet Disord
                BMC Musculoskelet Disord
                BMC Musculoskeletal Disorders
                BioMed Central (London )
                1471-2474
                21 November 2017
                21 November 2017
                2017
                : 18
                : 478
                Affiliations
                ISNI 0000 0001 0328 4908, GRID grid.5253.1, Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, ; Schlierbacher Landstraße 200a, D-69118 Heidelberg, Germany
                Article
                1835
                10.1186/s12891-017-1835-3
                5697353
                29162072
                5792fe3b-5101-4c31-8cda-a22a9b84be18
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 February 2017
                : 13 November 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Orthopedics
                shoulder arthroplasty,stemless shoulder arthroplasty,osteoarthritis,3d motion analysis,hux model

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