{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:30:18Z","timestamp":1790868618865,"version":"4.1.0"},"reference-count":76,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":1885,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:p>Stemless shoulder arthroplasty relies solely on cementless metaphyseal fixation and is designed to avoid stem-related problem such as intraoperative fractures, loosening, stress shielding or stress-risers for periprosthetic fractures. Many designs are currently on the market, although only six anatomic and two reverse arthroplasty designs have results published with a minimum of two-year follow-up. Compared to stemmed designs, clinical outcome is equally good using stemless designs in the short and medium-term follow-up, which is also the case for overall complication and revision rates. Intraoperative fracture rate is lower in stemless compared to stemmed designs, most likely due to the absence of intramedullary preparation and of the implantation of a stem. Radiologic abnormalities around the humeral implant are less frequent compared to stemmed implants, possibly related to the closer resemblance to native anatomy. Between stemless implants, several significant differences were found in terms of clinical outcome, complication and revision rates, although the level of evidence is low with high study heterogeneity; therefore, firm conclusions could not be drawn. There is a need for well-designed long-term randomized trials with sufficient power in order to assess the superiority of stemless over conventional arthroplasty, and of one design over another.<\/jats:p>\n                  <jats:p>Cite this article: EFORT Open Rev 2021;6:35-49. DOI: 10.1302\/2058-5241.6.200067<\/jats:p>","DOI":"10.1302\/2058-5241.6.200067","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T06:01:39Z","timestamp":1609740099000},"page":"35-49","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":63,"title":["Results of stemless shoulder arthroplasty: a systematic review and meta-analysis"],"prefix":"10.1530","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9837-9183","authenticated-orcid":false,"given":"Joost I.P.","family":"Willems","sequence":"first","affiliation":[{"name":"1Spaarne Gasthuis, Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"1Spaarne Gasthuis, Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger N.","family":"Sierevelt","sequence":"additional","affiliation":[{"name":"1Spaarne Gasthuis, Hoofddorp, The Netherlands"},{"name":"2Xpert Orthopedics, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel P.J.","family":"van den Bekerom","sequence":"additional","affiliation":[{"name":"3Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tjarco D.W.","family":"Alta","sequence":"additional","affiliation":[{"name":"1Spaarne Gasthuis, Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"van Noort","sequence":"additional","affiliation":[{"name":"1Spaarne Gasthuis, Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2021,1,4]]},"reference":[{"key":"2026070713284701200_bibr1-2058-5241.6.200067","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.jse.2010.11.017","article-title":"Complications of unconstrained shoulder prostheses","volume":"20","author":"Gonzalez","year":"2011","journal-title":"J Shoulder Elbow Surg"},{"key":"2026070713284701200_bibr2-2058-5241.6.200067","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.jse.2017.12.020","article-title":"Stress shielding of the humerus in press-fit anatomic shoulder arthroplasty: review and recommendations for evaluation","volume":"27","author":"Denard","year":"2018","journal-title":"J Shoulder Elbow Surg"},{"key":"2026070713284701200_bibr3-2058-5241.6.200067","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.jse.2018.08.037","article-title":"Postoperative radiographic findings of an uncemented convertible short stem for anatomic and reverse shoulder arthroplasty","volume":"28","author":"Raiss","year":"2019","journal-title":"J Shoulder Elbow Surg"},{"key":"2026070713284701200_bibr4-2058-5241.6.200067","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.2106\/JBJS.M.00378","article-title":"Radiographic changes around humeral components in shoulder arthroplasty","volume":"96","author":"Raiss","year":"2014","journal-title":"J Bone Jt Surg \u2013 Ser A"},{"key":"2026070713284701200_bibr5-2058-5241.6.200067","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s00264-009-0780-7","article-title":"Complications in shoulder arthroplasty: an analysis of 485 cases","volume":"34","author":"Aldinger","year":"2010","journal-title":"Int Orthop"},{"key":"2026070713284701200_bibr6-2058-5241.6.200067","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1007\/s00264-016-3138-y","article-title":"Stemless shoulder prosthesis for treatment of proximal humeral malunion does not require tuberosity osteotomy","volume":"40","author":"Ballas","year":"2016","journal-title":"Int Orthop"},{"key":"2026070713284701200_bibr7-2058-5241.6.200067","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s12306-017-0467-y","article-title":"Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? 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