Stemmed versus stemless humeral implants in anatomic total shoulder arthroplasty: a systematic review and meta-analysis.
- 1College of Medicine, University of Oklahoma, Oklahoma City, OK, USA.
- 2Department of Orthopaedics, Medical City Denton, Denton, TX, USA.
- 3College of Osteopathic Medicine, Kansas City University, Kansas City, MO, USA.
Abstract
Background
A recent advancement in anatomic total shoulder arthroplasty (aTSA) has been the development of stemless humeral implants The objective of this systematic review and meta-analysis is to compare outcomes of traditional stemmed humeral implants (S+) and stemless humeral implants (S-) in aTSA.Methods
A search was conducted across 7 databases. Titles and abstracts were screened for eligibility. Full texts were screened for inclusion. Demographic and study results were extracted from articles that met the inclusion criteria. Meta-analysis was conducted to evaluate outcomes.Results
Twenty-one studies were included, of which 19 met the inclusion criteria for meta-analysis. No studies were poor quality or at high risk of bias according to the quality assessment. A meta-analysis showed no significant difference in post-operative Constant scores (Cohen d = -0.27; 95% confidence interval [CI]: -0.79 to 0.25; P = .3), forward flexion(Cohen d = -0.07; 95% CI: -0.32 to 0.17; P = .56), abduction (Cohen d = -0.07; 95% CI: -0.46 to 0.33; P = .73), external rotation (Cohen d = -0.12; 95% CI: -0.39 to 0.15; P = .39), restoration of the center of rotation (Cohen d = 0.01; 95% CI: -0.58 to 0.60; P = .97), or revision risk (odds ratio = 1.14; 95% CI: 0.70-1.86; P = .59). However, S- demonstrated a significant reduction in operative time (Cohen d = 1.20; 95% CI: 0.62 to 1.78; P < .001) and intra-operative blood loss (Cohen d = 0.65; 95% CI: 0.52 to 0.77; P < .001).Conclusion
Both S+ and S- aTSAs provide equivalent functional and clinical outcomes, with S- providing some potential benefits such as decreased intra-operative blood loss and operative time. This implant may be particularly beneficial in younger patients with preserved metaphyseal bone quality.
Related
- Radiographic view strongly influences detection of humeral component migration after stemless shoulder arthroplasty
- Radiographic view strongly influences detection of humeral component migration after stemless shoulder arthroplasty
- Cost-effectiveness of anatomic total shoulder arthroplasty versus pyrocarbon hemiarthroplasty for glenohumeral osteoarthritis: a 10-year Markov cost-utility analysis
- Long-term outcomes of hemiarthroplasty and anatomic total shoulder arthroplasty for atraumatic humeral head avascular necrosis
- Asymmetric reaming compared to posterior augmented components for posterior glenoid wear and retroversion in anatomic total shoulder arthroplasty: a minimum ten-year follow-up outcome analysis
BibTeX
@article{dieu2026stemmed,
title = {{Stemmed versus stemless humeral implants in anatomic total shoulder arthroplasty: a systematic review and meta-analysis.}},
author = {Vincent Dieu and Troy B Puga and Tanner Haechten and McKenna W Box and Kyle P O'Connor and Brandon Levy and John T Riehl},
journal = {JSES reviews, reports, and techniques},
year = {2026},
month = sep,
doi = {10.1016/j.xrrt.2026.100881},
url = {https://europepmc.org/article/MED/42908885},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Stemmed versus stemless humeral implants in anatomic total shoulder arthroplasty: a systematic review and meta-analysis.
AU - Vincent Dieu
AU - Troy B Puga
AU - Tanner Haechten
AU - McKenna W Box
AU - Kyle P O'Connor
AU - Brandon Levy
AU - John T Riehl
PY - 2026
DA - 2026/09/11
JO - JSES reviews, reports, and techniques
DO - 10.1016/j.xrrt.2026.100881
UR - https://europepmc.org/article/MED/42908885
AB - Background A recent advancement in anatomic total shoulder arthroplasty (aTSA) has been the development of stemless humeral implants The objective of this systematic review and meta-analysis is to compare outcomes of traditional stemmed humeral implants (S+) and stemless humeral implants (S-) in aTSA.Methods A search was conducted across 7 databases. Titles and abstracts were screened for eligibility. Full texts were screened for inclusion. Demographic and study results were extracted from articles that met the inclusion criteria. Meta-analysis was conducted to evaluate outcomes.Results Twenty-one studies were included, of which 19 met the inclusion criteria for meta-analysis. No studies were poor quality or at high risk of bias according to the quality assessment. A meta-analysis showed no significant difference in post-operative Constant scores (Cohen d = -0.27; 95% confidence interval [CI]: -0.79 to 0.25; P = .3), forward flexion(Cohen d = -0.07; 95% CI: -0.32 to 0.17; P = .56), abduction (Cohen d = -0.07; 95% CI: -0.46 to 0.33; P = .73), external rotation (Cohen d = -0.12; 95% CI: -0.39 to 0.15; P = .39), restoration of the center of rotation (Cohen d = 0.01; 95% CI: -0.58 to 0.60; P = .97), or revision risk (odds ratio = 1.14; 95% CI: 0.70-1.86; P = .59). However, S- demonstrated a significant reduction in operative time (Cohen d = 1.20; 95% CI: 0.62 to 1.78; P < .001) and intra-operative blood loss (Cohen d = 0.65; 95% CI: 0.52 to 0.77; P < .001).Conclusion Both S+ and S- aTSAs provide equivalent functional and clinical outcomes, with S- providing some potential benefits such as decreased intra-operative blood loss and operative time. This implant may be particularly beneficial in younger patients with preserved metaphyseal bone quality.
SN - 2666-6391
ER -