Clinical and radiological results of a cementless short stem shoulder prosthesis at minimum follow-up of two years

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Abstract
Uncemented short stem shoulder arthroplasty combines the advantages of a bone-saving implantation with a straightforward revision option. Uncemented humeral long stems can be associated with stress shielding and loosening. Therefore, we analysed the clinical and radiological outcome of a short stem shoulder prosthesis with metaphyseal fixation. This two-centre study included 82 total shoulder arthroplasties in 80 patients with short stem shoulder prosthesis and a cemented polyethylene glenoid performed between 2010 and 2012. Sixty-eight shoulders had primary osteoarthritis, eight shoulders had post traumatic sequelae and six had other diagnoses. Minimum follow-up was two years. Outcome data included the Constant Score (CS), Subjective Shoulder Value (SSV), Pain Scale (0–15) and range of motion. Radiographic evaluation was done in shoulders with primary osteoarthritis in a standard view. The mean clinical and radiological follow-up was 31.2 ± 7.2 months (20–52). CS improved from 36.7 ± 15.2 % to 90.4 ± 16.4 % and SSV improved from 39.4 ± 15.5 points to 85.5 ± 13.2 points (p < 0.0001). Pain was rated as mild or none in 76 shoulders (92.7 %) with a mean value of 13.2 ± 2.6. The mean active flexion was 157.0 ± 24.7°, abduction was 152.6 ± 29.1° and the active external rotation was 38.2 ± 14.8° at recent follow-up. Radiographic assessment was done in 44 shoulders. Six shoulders (13.6 %) showed features of slight stress shielding at the medial cortex and no stem with subsidence was found. Three glenoids (6.8 %) had minor radiolucent lines. Uncemented short stem shoulder arthroplasty with a cemented polyethylene glenoid can yield a stable fixation with a good clinical outcome at minimum follow-up of two years.

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