title: Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening.
abstract: OBJECTIVE
  A stemless reverse shoulder prosthesis with humeral cup was developed to allow stemless press-fit fixation, to preserve bone stock. Our hypothesis was that a stemless reverse shoulder arthroplasty could produce the same functional results without compromising humeral fixation.
  
  
  METHODS
  This is a continuous, prospective, single-surgeon series including prostheses implanted from 2004 to 2009. Patients received pre- and postoperative clinical evaluation with measurement of joint mobility, the Oxford Shoulder score, and the Constant-Murley score by independent evaluators. Standard radiographs and computed tomographic arthrography were performed.
  
  
  RESULTS
  Fifty-six implants were reviewed at a mean of 58 months (38-95). The Constant-Murley score improved from 29 to 62 points and the Oxford Shoulder score from 46 to 17 points. Active elevation in forward flexion improved from 79° to 140°. One intraoperative complication was recorded: a metaphyseal-diaphyseal humeral bone crack without consequence. One revision surgery due to early instability was performed using a conventional implant. No humeral loosening was observed. Five cases of scapular notching were reported.
  
  
  CONCLUSIONS
  This is the first study reporting results with mid-term follow-up for a stemless reverse shoulder arthroplasty. The clinical results are comparable to conventional prostheses with stem. The absence of a humeral stem preserves bone stock for possible later revisions.
authors: Department of Orthopaedic Surgery, University Hospital Center of La Réunion Island, Saint-Pierre, La Réunion, France. richardballas@yahoo.fr
authors: Richard
authors: R
authors: Ballas
authors: Laurent
authors: L
authors: Béguin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000295:instrumentation*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cases Series; Level IV; Shoulder arthroplasty; Treatment Study; reverse shoulder arthroplasty; stemless prosthesis