This prospective multicenter study followed a stemless anatomic total shoulder replacement using a ceramic head and cemented pegged polyethylene glenoid. All patients had glenohumeral osteoarthritis with an intact rotator cuff. It asks whether this ceramic-head stemless design gives durable clinical and radiographic results at mid-term (5-year) follow-up.
For the exam-relevant decision, anatomic TSR requires an intact rotator cuff; a torn cuff pushes you toward reverse arthroplasty, and these authors excluded cuff-deficient shoulders entirely.
The teaching point is that glenoid fixation, not the humeral side, drives anatomic TSR longevity. The single revision here was for glenoid loosening while the stemless humeral component stayed solidly ingrown. Use the Lazarus score to track glenoid radiolucency on serial films, and remember CT is more sensitive than plain radiographs when symptoms and X-rays disagree.
The stemless design preserves proximal humeral bone and eases future humeral revision, while the ceramic head is proposed to cut polyethylene wear and osteolysis versus a metal head. Finally, counsel patients that new AC joint pain after a well-functioning TSR is common and usually treatable with injection, not a sign of implant failure.
This prospective multicenter study followed a stemless anatomic total shoulder replacement using a ceramic head and cemented pegged polyethylene glenoid. All patients had glenohumeral osteoarthritis with an intact rotator cuff. It asks whether this ceramic-head stemless design gives durable clinical and radiographic results at mid-term (5-year) follow-up.
For the exam-relevant decision, anatomic TSR requires an intact rotator cuff; a torn cuff pushes you toward reverse arthroplasty, and these authors excluded cuff-deficient shoulders entirely.
The teaching point is that glenoid fixation, not the humeral side, drives anatomic TSR longevity. The single revision here was for glenoid loosening while the stemless humeral component stayed solidly ingrown. Use the Lazarus score to track glenoid radiolucency on serial films, and remember CT is more sensitive than plain radiographs when symptoms and X-rays disagree.
The stemless design preserves proximal humeral bone and eases future humeral revision, while the ceramic head is proposed to cut polyethylene wear and osteolysis versus a metal head. Finally, counsel patients that new AC joint pain after a well-functioning TSR is common and usually treatable with injection, not a sign of implant failure.