{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T20:21:31Z","timestamp":1789762891352,"version":"4.0.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","license":[{"start":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T00:00:00Z","timestamp":1601251200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Stemless humeral components for anatomic total shoulder arthroplasty (aTSA) have several reported potential benefits compared with stemmed implants. However, we are aware of no Level-I, randomized controlled trials (RCTs) that have compared stemless implants with stemmed implants in patients managed with aTSA. We sought to directly compare the short-term clinical and radiographic outcomes of stemless and stemmed implants to determine if the stemless implant is noninferior to the stemmed implant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a prospective, multicenter, single-blinded RCT comparing stemless and short-stemmed implants in patients managed with aTSA. Range-of-motion measurements and American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Constant scores were obtained at multiple time points. Device-related complications were recorded. Radiographic evaluation for evidence of loosening, fractures, dislocation, or other component complications was performed. Statistical analysis for noninferiority was performed at 2 years of follow-up for 3 primary end points: ASES score, absence of device-related complications, and radiographic signs of loosening. All other data were compared between cohorts at all time points as secondary measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Two hundred and sixty-five shoulders (including 176 shoulders in male patients and 89 shoulders in female patients) were randomized and received the allocated treatment. The mean age of the patients (and standard deviation) was 62.6 \u00b1 9.3 years, and 99% of the shoulders had a primary diagnosis of osteoarthritis. At 2 years, the mean ASES score was 92.5 \u00b1 14.9 for the stemless cohort and 92.2 \u00b1 13.5 for the stemmed cohort (p value for noninferiority test, &lt;0.0001), the proportion of shoulders without device-related complications was 92% (107 of 116) for the stemless cohort and 93% (114 of 123) for the stemmed cohort (p value for noninferiority test, 0.0063), and no shoulder in either cohort had radiographic signs of loosening. Range-of-motion measurements and ASES, SANE, and Constant scores did not differ significantly between cohorts at any time point within the 2-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>At 2 years of follow-up, the safety and effectiveness of the stemless humeral implant were noninferior to those of the stemmed humeral implant in patients managed with aTSA for the treatment of osteoarthritis. These short-term results are promising given the potential benefits of stemless designs over traditional, stemmed humeral components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.01478","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T14:18:00Z","timestamp":1601302680000},"page":"1974-1984","source":"Crossref","is-referenced-by-count":58,"title":["Prospective, Blinded, Randomized Controlled Trial of Stemless Versus Stemmed Humeral Components in Anatomic Total Shoulder Arthroplasty"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9807-829X","authenticated-orcid":false,"given":"J. Michael","family":"Wiater","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, William Beaumont Hospital, Beaumont Health, Royal Oak, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1699-0841","authenticated-orcid":false,"given":"Jonathan C.","family":"Levy","sequence":"additional","affiliation":[{"name":"Holy Cross Orthopedic Research Institute, Fort Lauderdale, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-585X","authenticated-orcid":false,"given":"Stephen A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Orthopaedics Northeast, Parkview Orthopaedic Hospital, Fort Wayne, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3264-5738","authenticated-orcid":false,"given":"Stephen F.","family":"Brockmeier","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2440-067X","authenticated-orcid":false,"given":"Thomas R.","family":"Duquin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Jacobs School of Medicine, University at Buffalo, The State University of New York, Buffalo, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4990-4919","authenticated-orcid":false,"given":"Jonathan O.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, William Beaumont Hospital, Beaumont Health, Royal Oak, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1357-1083","authenticated-orcid":false,"given":"Timothy P.","family":"Codd","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Maryland Medical System and St Joseph\u2019s Hospital, Towson, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,9,28]]},"reference":[{"issue":"3","key":"bib1-20230811","doi-asserted-by":"crossref","first-page":"594","DOI":"10.2106\/JBJS.H.00439","article-title":"Periprosthetic humeral fractures during shoulder arthroplasty","volume":"91","author":"Athwal","year":"2009","journal-title":"J Bone Joint Surg Am."},{"issue":"19","key":"bib2-20230811","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.2106\/JBJS.J.01945","article-title":"Periprosthetic fractures associated with primary total shoulder arthroplasty and primary humeral head replacement: a thirty-three-year study","volume":"94","author":"Singh","year":"2012","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib3-20230811","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1302\/0301-620X.83B2.0830213","article-title":"Cementless surface replacement arthroplasty of the shoulder. 5- to 10-year results with the Copeland Mark-2 prosthesis","volume":"83","author":"Levy","year":"2001","journal-title":"J Bone Joint Surg Br."},{"issue":"3","key":"bib4-20230811","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jse.2004.01.005","article-title":"Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder","volume":"13","author":"Levy","year":"2004","journal-title":"J Shoulder Elbow Surg."},{"issue":"6","key":"bib5-20230811","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.jse.2009.12.009","article-title":"Results of a new stemless shoulder prosthesis: radiologic proof of maintained fixation and stability after a minimum of three years\u2019 follow-up","volume":"19","author":"Huguet","year":"2010","journal-title":"J Shoulder Elbow Surg."},{"issue":"5","key":"bib6-20230811","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s00264-016-3371-4","article-title":"Is the humeral stem useful in anatomic total shoulder arthroplasty?","volume":"41","author":"Collin","year":"2017","journal-title":"Int Orthop."},{"issue":"9","key":"bib7-20230811","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1016\/j.jse.2017.02.017","article-title":"Nine-year outcome after anatomic stemless shoulder prosthesis: clinical and radiologic results","volume":"26","author":"Hawi","year":"2017","journal-title":"J Shoulder Elbow Surg."},{"issue":"7","key":"bib8-20230811","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.2106\/JBJS.15.01350","article-title":"Spare the canal: stemless shoulder arthroplasty is finally here: commentary on an article by R. Sean Churchill, MD, et al.: \u201cClinical and radiographic outcomes of the Simpliciti canal-sparing shoulder arthroplasty system. A prospective two-year multicenter study\u201d.","volume":"98","author":"Athwal","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib9-20230811","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s10195-012-0216-9","article-title":"Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis: a comparison of the functional outcome after a minimum of two years follow-up","volume":"14","author":"Berth","year":"2013","journal-title":"J Orthop Traumatol."},{"issue":"6","key":"bib10-20230811","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."},{"issue":"2","key":"bib11-20230811","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.jse.2012.04.016","article-title":"Impact of prosthetic design on clinical and radiologic outcomes of total shoulder arthroplasty: a prospective study","volume":"22","author":"Razmjou","year":"2013","journal-title":"J Shoulder Elbow Surg."},{"issue":"2","key":"bib12-20230811","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jse.2016.09.001","article-title":"Is the stemless humeral head replacement clinically and radiographically a secure equivalent to standard stem humeral head replacement in the long-term follow-up? A prospective randomized trial","volume":"26","author":"Uschok","year":"2017","journal-title":"J Shoulder Elbow Surg."},{"issue":"3","key":"bib13-20230811","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4103\/0973-6042.140113","article-title":"Short stem shoulder replacement","volume":"8","author":"Bell","year":"2014","journal-title":"Int J Shoulder Surg."},{"issue":"1","key":"bib14-20230811","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jse.2014.04.005","article-title":"The TESS reverse shoulder arthroplasty without a stem in the treatment of cuff-deficient shoulder conditions: clinical and radiographic results","volume":"24","author":"Teissier","year":"2015","journal-title":"J Shoulder Elbow Surg."},{"issue":"7","key":"bib15-20230811","doi-asserted-by":"crossref","first-page":"552","DOI":"10.2106\/JBJS.15.00181","article-title":"Clinical and radiographic outcomes of the Simpliciti canal-sparing shoulder arthroplasty system: a prospective two-year multicenter study","volume":"98","author":"Churchill","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib16-20230811","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1007\/s00264-018-3779-0","article-title":"Long-term survivorship of stemless anatomical shoulder replacement","volume":"42","author":"Beck","year":"2018","journal-title":"Int Orthop."},{"issue":"12","key":"bib17-20230811","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1016\/j.jse.2018.05.039","article-title":"Clinical and radiologic outcomes following total shoulder arthroplasty using Arthrex Eclipse stemless humeral component with minimum 2 years\u2019 follow-up","volume":"27","author":"Gallacher","year":"2018","journal-title":"J Shoulder Elbow Surg."},{"issue":"8","key":"bib18-20230811","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.jse.2019.01.010","article-title":"The short-term survival of total stemless shoulder arthroplasty for osteoarthritis is comparable to that of total stemmed shoulder arthroplasty: a Nordic Arthroplasty Register Association study","volume":"28","author":"Rasmussen","year":"2019","journal-title":"J Shoulder Elbow Surg."},{"issue":"12","key":"bib19-20230811","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1007\/s00402-011-1368-4","article-title":"Results of the Total Evolutive Shoulder System (TESS): a single-centre study of 56 consecutive patients","volume":"131","author":"Kadum","year":"2011","journal-title":"Arch Orthop Trauma Surg."},{"issue":"4","key":"bib20-20230811","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s11678-011-0137-x","article-title":"Die metaphys\u00e4r verankerte prothese bei posttraumatischer und prim\u00e4rer omarthrose","volume":"6","author":"Schoch","year":"2011","journal-title":"Obere Extrem."},{"issue":"2","key":"bib21-20230811","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s11678-012-0162-4","article-title":"Indikationsspezifische mittelfristige ergebnisse der anatomischen kurzschaft-schulterprothese","volume":"7","author":"Berth","year":"2012","journal-title":"Obere Extrem."},{"issue":"1","key":"bib22-20230811","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s11678-011-0152-y","article-title":"Die schaftfreie Eclipse-Prothese \u2013 indikation und mittelfristige ergebnisse","volume":"7","author":"Brunner","year":"2012","journal-title":"Obere Extrem."},{"issue":"9","key":"bib23-20230811","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jse.2012.12.005","article-title":"Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening","volume":"22","author":"Ballas","year":"2013","journal-title":"J Shoulder Elbow Surg."},{"issue":"1","key":"bib24-20230811","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jse.2017.05.026","article-title":"Short-term clinical outcome of an anatomic short-stem humeral component in total shoulder arthroplasty","volume":"27","author":"Romeo","year":"2018","journal-title":"J Shoulder Elbow Surg."},{"issue":"4","key":"bib25-20230811","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1302\/0301-620X.96B3.32702","article-title":"Short-stem uncemented primary reverse shoulder arthroplasty: clinical and radiological outcomes","volume":"96-B","author":"Giuseffi","year":"2014","journal-title":"Bone Joint J."},{"issue":"3","key":"bib26-20230811","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s11420-011-9221-4","article-title":"Total shoulder arthroplasty utilizing mini-stem humeral components: technique and short-term results","volume":"7","author":"Jost","year":"2011","journal-title":"HSS J."},{"issue":"3","key":"bib28-20230811","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jse.2004.10.009","article-title":"Normalization of the Constant score","volume":"14","author":"Katolik","year":"2005","journal-title":"J Shoulder Elbow Surg."},{"issue":"1","key":"bib29-20230811","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jse.2016.06.007","article-title":"Determining the minimal clinically important difference for the American Shoulder and Elbow Surgeons score, Simple Shoulder Test, and visual analog scale (VAS) measuring pain after shoulder arthroplasty","volume":"26","author":"Tashjian","year":"2017","journal-title":"J Shoulder Elbow Surg."},{"issue":"12","key":"bib30-20230811","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.1007\/s11999-016-4968-z","article-title":"What change in American Shoulder and Elbow Surgeons score represents a clinically important change after shoulder arthroplasty?","volume":"474","author":"Werner","year":"2016","journal-title":"Clin Orthop Relat Res."},{"issue":"8","key":"bib31-20230811","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1302\/0301-620X.89B8.19424","article-title":"The use of the Oxford hip and knee scores","volume":"89","author":"Murray","year":"2007","journal-title":"J Bone Joint Surg Br."},{"issue":"2","key":"bib32-20230811","doi-asserted-by":"crossref","first-page":"72","DOI":"10.5435\/00124635-201002000-00002","article-title":"Challenges with health-related quality of life assessment in arthroplasty patients: problems and solutions","volume":"18","author":"Singh","year":"2010","journal-title":"J Am Acad Orthop Surg."},{"issue":"3","key":"bib33-20230811","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1002\/art.23318","article-title":"Responsiveness of six outcome assessment instruments in total shoulder arthroplasty","volume":"59","author":"Angst","year":"2008","journal-title":"Arthritis Rheum."},{"issue":"9","key":"bib34-20230811","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.jse.2015.02.023","article-title":"Midterm results of stemless shoulder arthroplasty: a prospective study","volume":"24","author":"Habermeyer","year":"2015","journal-title":"J Shoulder Elbow Surg."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.19.01478","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:43:54Z","timestamp":1787751834000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.19.01478"}},"subtitle":["Results at Short-Term Follow-up"],"short-title":[],"issued":{"date-parts":[[2020,9,28]]},"references-count":33,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.19.01478","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,28]]}}}