Promising short-term results after anatomical total shoulder arthroplasty for glenohumeral osteoarthritis with a novel stemless humeral implant in combination with a pegged all-polyethylene bone ingrowth glenoid component.

Abstract

Purpose: Stemless anatomical shoulder arthroplasty offers numerous potential advantages over stemmed systems. The aim of this prospective study was to evaluate the clinical and radiological 2-year results of a novel metaphyseal anchored stemless shoulder system (Global Icon™ Stemless Shoulder System, DePuy Synthes, Warsaw, IN, USA).

Methods: Thirty patients with primary osteoarthritis, 14 males and 6 females, were prospectively included in the study. Two-year follow-up data were analyzed for 20 patients. The average age and BMI were 63.4 years and 27.6 kg/m2. The adjusted Constant-Murley Score (aCS), Oxford Shoulder Score (OSS), and EQ-5D-5L were used as primary endpoints to reflect postoperative clinical improvement. Postoperative radiographs in two planes were analyzed for implant loosening and migration.

Results: There was an overall clinical improvement 2 years postoperatively. The aCS increased from 58.3 ± 17.7 to 113.7 ± 15.6 points (p < 0.0001). The OSS score improved from 25.5 ± 6.1 to 43.9 ± 6.1 points (p < 0.0001). The EQ-5D-5L value score increased on average from 0.7 ± 0.2 to 0.9 ± 0.1 (p = 0.0004). There was no implant loosening or migration. No revisions were required.

Conclusion: In summary, the examined prosthesis system achieved very good clinical and radiographic results 2 years postoperatively without implant failure. Shoulder function and quality of life improved significantly. These results are encouraging for prostheses with bone-preserving designs which rely on peripheral humeral fixation, though more long-term results are needed.

Level of evidence: Level IV; Case Series; Treatment Study.