Outcomes of ream and run shoulder arthroplasty with a stemless humeral component
Matthew R. Cohn; Tyler A. Luthringer; Liam T. Kane; Alayna K. Vaughn; Daniel Kwak; Surena Namdari; Mark D. Lazarus
Full length article · Volume 18, Issue 4, Pages 741–747
Background
The question this study asked
The ream-and-run procedure has conventionally been performed using standard-length stems that engage the shaft of the humerus. Stemless humeral components have gained ground in recent years because they preserve metaphyseal bone and shorten operative times. Until this study, nobody had reported clinical outcomes for the ream-and-run procedure performed with a stemless humeral component.
Methods
How the study was conducted
The authors retrospectively reviewed every patient who underwent ream-and-run with a stemless humeral component at a single institution between January 2017 and May 2021. Preoperative radiographs were assessed for Walch classification, glenoid version, and posterior humeral head decentering. Glenoid version and posterior humeral head decentering were reassessed on radiographs taken three months after surgery, and clinical outcomes were measured at a minimum of two years postoperatively.
Results
What the measurements showed
Eighteen shoulders across seventeen patients were included, and fifteen of those patients, or 88 percent, returned to exercise at a median of sixteen weeks. At minimum two-year follow-up, the mean Visual Analog Scale score was 2.5, the mean American Shoulder and Elbow Surgeons score was 79.6, the mean Simple Shoulder Test score was 9.9, and the mean Single Assessment Numeric Evaluation score was 80. On imaging, corrective humeral head recentering within 5 percent was achieved in 64 percent of cases.
Discussion
What it means
The clinical and radiographic results here suggest that stemless implants can deliver patient-reported outcomes comparable to stemmed implants in the ream-and-run procedure, while adding two advantages: preserved bone stock and shorter time in the operating room.
