Perspective from Lawrence V. Gulotta, MD
Source:

Jawa A. Point/counterpoint: Stem vs. stemless: Pro stemless. Presented at: American Shoulder and Elbow Surgeons Specialty Day Meeting; Feb. 27, 2021 (virtual meeting).

Disclosures: Jawa reports he receives research support from DJO Global; is a consultant or on the speakers bureau for DJO Global and DePuy-Synthes; is a designer for Ignite Orthopedics; receives royalties from DePuy-Synthes and Ignite Orthopedics; has ownership or equity in Boston Outpatient Surgical Suites and Ignite Orthopedics; and is on the editorial board of the Journal of Shoulder and Elbow Surgery.
March 01, 2021
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Stemless implants may have advantages over stemmed implants in shoulder arthroplasty

Perspective from Lawrence V. Gulotta, MD
Source:

Jawa A. Point/counterpoint: Stem vs. stemless: Pro stemless. Presented at: American Shoulder and Elbow Surgeons Specialty Day Meeting; Feb. 27, 2021 (virtual meeting).

Disclosures: Jawa reports he receives research support from DJO Global; is a consultant or on the speakers bureau for DJO Global and DePuy-Synthes; is a designer for Ignite Orthopedics; receives royalties from DePuy-Synthes and Ignite Orthopedics; has ownership or equity in Boston Outpatient Surgical Suites and Ignite Orthopedics; and is on the editorial board of the Journal of Shoulder and Elbow Surgery.
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Although stemmed and stemless implants for shoulder arthroplasty have equivalent outcomes, a presenter noted stemless implants are more technically forgiving, efficient, lead to less stress shielding and are easier to revise.

In his presentation at the American Shoulder and Elbow Surgeons Specialty Day Meeting, Andrew Jawa, MD, noted stemless implants provide excellent short-term outcomes and few complications. Although published literature has shown equivalent outcomes between stemless and stemmed implants, Jawa noted it is easier to place the head of a stemless implant anatomically.

“It follows that if you have a simpler technique, you are going to have a more efficient surgery. It is going to be faster,” Jawa said.

Andrew Jawa
Andrew Jawa

He added stemless arthroplasties will have stress shielding, but less than that of stemmed arthroplasty. Jawa also noted that stemless implants are easier to revise.

However, currently, stemless implants cost more than stemmed implants, according to Jawa.

“We have done some work that shows the implant takes up the highest proportion of the cost in an episode of care and the cost is higher for a stemless at this point,” Jawa said. “But as more and more people do stemless, it is only about 6%, and fewer people do stemmed, that price is going to come down.”