Comparison of revision rates and radiographic observations of long and short, uncoated and coated humeral stem designs in total shoulder arthroplasty

There is no consensus on outcomes of long versus short and uncoated versus coated uncemented stems in total shoulder arthroplasty (TSA). We reviewed the literature to compare revision rates and adverse radiographic observations at ⩾ 2 years of various uncemented humeral stem designs. We performed an electronic PubMed search for studies on uncemented primary TSA that reported one or more of the following observations at ⩾ 2 years for distinct stem designs: stem revision; subsidence; stress shielding; radiolucent lines; and humeral loosening. The search returned 258 records, from which 20 articles (22 cohorts) met the inclusion criteria. The most frequently reported designs were short uncoated stems (7/13 cohorts) at < 3 years and long uncoated stems (8/9 cohorts) at > 3 years. The incidences of revisions and adverse radiographic observations were lower for short coated designs, compared with short and long uncoated designs, but these findings should be confirmed by prospective studies with a longer follow-up. Cite this article: EFORT Open Rev 2019;4:70-76. DOI: 10.1302/2058-5241.4.180046.