Long-term follow-up of stemless anatomic shoulder arthroplasty with a ceramic humeral head prosthesis: a multicenter study

TL;DR

A study found that ceramic shoulder implants used in a specific type of surgery had good long-term results with high survival rates and few complications.

Contribution

This study provides the first long-term clinical and radiographic outcomes of stemless anatomic shoulder arthroplasty with a ceramic humeral head prosthesis.

Findings

Prosthesis survival at 13 years was 89.9% for all revisions and 90.8% for humeral component revision.

Osteolysis, wear, and aseptic loosening were rare and confined to the glenoid side.

Nine out of ten prostheses remained functional after 10 years.

Abstract

Stemless anatomic total shoulder arthroplasty (aTSA) with ceramic implants have shown promising midterm clinical outcomes. However, long-term clinical data on ceramic humeral head prostheses are not available. We therefore evaluated the long-term clinical and radiographic outcomes, including implant survival and complication rates, of a stemless ceramic humeral head prosthesis in different shoulder pathologies.

In this prospective, multicenter, observational study, patients underwent stemless aTSA using a ceramic humeral head prosthesis. We recorded Constant–Murley Scores (CSs), radiolucent lines (RLLs), complications, and long-term prosthesis survival.

We treated 238 patients (238 shoulders) with a stemless ceramic humeral head prosthesis. Clinical and radiographic outcomes were recorded from 120 shoulders at a median follow-up of 125.4 months, and complications from 229 shoulders. At final follow-up, CSs improved significantly from preoperative values (P < .0001). Although RLLs appeared both at the glenoid and humerus, osteolysis, wear, and aseptic loosening were rare (0.9%) and confined to the glenoid side; no aseptic loosening of the humeral component was noted. Prosthesis survival at 13 years reached 89.9% for all revisions and 90.8% for humeral component revision.

Stemless aTSA with a ceramic humeral head prosthesis resulted in good CSs, a low number of clinically relevant RLLs, low incidences of glenoid osteolysis and aseptic loosening, no aseptic loosening of the humeral component, and high prosthesis survival rates in the long term. Moreover, nine out of ten prostheses remained in situ and were functional after 10 years, confirming the long-term success of this ceramic prosthesis.

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