Patient reported outcome after stemmed versus stemless total shoulder arthroplasty for glenohumeral osteoarthritis: a patient-blinded randomized clinical trial

Abstract Background Stemless shoulder arthroplasty systems with uncemented metaphyseal fixation have been used in Europe for glenohumeral osteoarthritis since 2004 [1]. The stemless design has several theoretical advantages compared with the stemmed shoulder arthroplasty systems: restoring patients’ anatomy, preserving humeral bone stock, and few complications in component removal if the need for a revision arthroplasty arises. The purpose of the study is to compare the short-term, patient-reported outcome of stemless and stemmed total shoulder arthroplasty. Materials and methods A randomized clinical trial will be conducted. Eighty patients with clinical and radiological signs of primary or posttraumatic glenohumeral osteoarthritis, computerized tomography (CT) scan-verified adequate glenoid bone stock, and no total rupture of rotator cuff tendons verified by a magnetic resonance imaging (MRI) scan will randomly be allocated to a stemless or stemmed total shoulder arthroplasty (TSA). The primary outcome will be the Western Ontario Osteoarthritis Shoulder (WOOS) score at 12 months. Secondary outcomes are the WOOS score at three months and the Oxford Shoulder Score (OSS) and EQ-5D at 3 and 12 months. All complications, including glenoid and humeral component loosening, instability, rotator cuff tear, intraoperative and postoperative periprosthetic fracture, nerve injury, infection, deltoid injury, and symptomatic deep venous thrombosis, will be reported. Discussion Findings will provide patients with better information about the potential benefits and harms of stemless and stemmed total shoulder arthroplasty and will assist shoulder surgeons and patients in decision-making.