The short- to midterm effectiveness of stemless prostheses compared to stemmed prostheses for patients who underwent tot
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(2019) 14:469
RESEARCH ARTICLE
Open Access
The short- to midterm effectiveness of stemless prostheses compared to stemmed prostheses for patients who underwent total shoulder arthroplasty: a meta-analysis Wei Peng1†, Yufu Ou2†, Chenglong Wang2†, Jianxun Wei2, Xiaoping Mu2* and Zhian He3*
Abstract Background: To systematically compare the short- to midterm effectiveness of stemless prostheses to that of stemmed prostheses for patients who underwent total shoulder arthroplasty (TSA) and to provide a guideline for clinical decision-making. Methods: PubMed, the Cochrane Library, and Web of Science were searched with the given search terms until July 2019 to identify published articles evaluating the clinical outcomes for stemless prostheses compared with stemmed prostheses for patients who underwent TSA. Data extraction and the quality assessment of the included studies were independently performed by two authors. Stata software 14.0 was used to analyze and synthesize the data. Results: Two randomized controlled trials and six case-controlled studies with a total of 347 shoulders were included in this meta-analysis. The results of this meta-analysis showed that there were no significant differences between the stemless and stemmed prostheses in terms of the Constant score, pain score, strength, activities of daily living, postoperative range of motion (ROM), and postoperative maximum active ROM. Conclusions: This is the first meta-analysis reporting the clinical results of stemless TSA in the short- to midterm follow-up period. Both types of shoulder prostheses were similar in achieving satisfactory clinical outcomes. Keywords: Total shoulder arthroplasty, Stemless, Stemmed, Clinical effectiveness, Meta-analysis
Introduction Conventional stemmed total shoulder arthroplasty (sTSA) has been considered the standard surgical procedure for patients with primary glenohumeral osteoarthritis because of its outstanding clinical results related to pain relief and restoration of range of motion (ROM), especially in improving patients’ postoperative quality of life [1–3]. However, with the increase in the number of patients who have undergone TSA and the length of follow-up, complications related to the humeral stem, * Correspondence: † Wei Peng, Yufu Ou and Chenglong Wang contributed equally to this work. 2 Department of Orthopaedics, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China 3 Department of Orthopaedics, The Affiliated Chencun Hospital of Shunde Hospital, Southern Medical University, Foshan 528300, China Full list of author information is available at the end of the article
which include intraoperative and postoperative periprosthetic fractures, bone stock loss, malpositioning of the humeral component and metaphyseal stress-shielding, have been reported [4–6]. To reduce the above-mentioned potential risks associated with the humeral stem, a new generation of stemless total shoulder prostheses, such as the Total Evolutive Shoulder System (TESS; Biomet Inc. Warsaw, US), was introduced i
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