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Background <p>The purpose of this study was to assess the long-term results of the stemless onlay Comprehensive Nano reverse total shoulder arthroplasty (rTSA) system.</p> Methods <p>We evaluated 35 shoulders at an average follow-up of 106 ± 14.6 months (range, 80–135) (follow-up rate 66%). Patients were evaluated via the Constant–Murley scale, the DASH score (Disabilities of the Arm, Shoulder and Hand) and the subjective shoulder value (SSV). Furthermore, a visual analog scale (VAS) for pain intensity was used. The passive glenohumeral range of motion and active total range of motion were recorded.</p> <p>Radiographic assessment was performed on true antero-posterior and axillary views.</p> Results <p>The mean age at surgery was 72.8 ± 6.7 years (range, 47–82). Four patients were revised to a stemmed implant during the follow-up period and were excluded from further assessment. In the remaining group, the Constant score was 82.9 ± 13.1 (range, 40–97), the DASH score was 10.6 ± 17.3 (range, 0–77.5), the SSV was 85.0 ± 18.1 (range, 10–100), and the VAS score for pain was 0.9 ± 1.7/10 (range, 0–7).</p> <p>The mean active flexion and abduction values were 159.8 ± 13.8 and 155.9 ± 20.1, whereas the active external and internal rotation values averaged 34.8 ± 15.3 and 88.9 ± 7.9, respectively.</p> <p>Grade I radiolucency lines (RLLs) were found in 4 patients (14.3%). RLLs &gt; 1 mm were not observed. Two patients experienced early varus displacement of the humeral tray with full reintegration without revision. Revisions to a stemmed implant were performed for atraumatic peg breakage of the humeral tray in 2 patients, early septic loosening in one patient and periprosthetic fracture in one patient.</p> <p>Grade 1 notching was found in 17.9%, and acromion stress fracture was found in 3.6%. Three patients experienced postoperative neurological deficits, with complete recovery in 2 patients.</p> Conclusions <p>Compared with published data on stemmed and stemless rTSA, the comprehensive Nano rTSA system in the present study has comparable or even superior clinical outcomes at long-term follow-up. The rates of implant-associated complications and revision, however, are high compared with those reported in the literature.</p> Trial registration <p>Retrospectively registered on 6th August 2025 German Clinical Trial Register, clinical trial number DRKS00037624, https//www.drks.de/DRKS00037624.</p>

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Long-term clinical and radiological outcomes of a stemless reverse shoulder implant that is fallen out of favor - stemless nano-reverse shoulder arthroplasty

  • 期刊论文

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  • 发表日期：

    2026年1月23日

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  • Johannes E. Plath,
  • Nicolas Saiczek,
  • Edgar Mayr,
  • Christian Schoch,
  • Johann Wasmaier,
  • Wolfgang Vogt

摘要

Background

The purpose of this study was to assess the long-term results of the stemless onlay Comprehensive Nano reverse total shoulder arthroplasty (rTSA) system.

Methods

We evaluated 35 shoulders at an average follow-up of 106 ± 14.6 months (range, 80–135) (follow-up rate 66%). Patients were evaluated via the Constant–Murley scale, the DASH score (Disabilities of the Arm, Shoulder and Hand) and the subjective shoulder value (SSV). Furthermore, a visual analog scale (VAS) for pain intensity was used. The passive glenohumeral range of motion and active total range of motion were recorded.

Radiographic assessment was performed on true antero-posterior and axillary views.

Results

The mean age at surgery was 72.8 ± 6.7 years (range, 47–82). Four patients were revised to a stemmed implant during the follow-up period and were excluded from further assessment. In the remaining group, the Constant score was 82.9 ± 13.1 (range, 40–97), the DASH score was 10.6 ± 17.3 (range, 0–77.5), the SSV was 85.0 ± 18.1 (range, 10–100), and the VAS score for pain was 0.9 ± 1.7/10 (range, 0–7).

The mean active flexion and abduction values were 159.8 ± 13.8 and 155.9 ± 20.1, whereas the active external and internal rotation values averaged 34.8 ± 15.3 and 88.9 ± 7.9, respectively.

Grade I radiolucency lines (RLLs) were found in 4 patients (14.3%). RLLs > 1 mm were not observed. Two patients experienced early varus displacement of the humeral tray with full reintegration without revision. Revisions to a stemmed implant were performed for atraumatic peg breakage of the humeral tray in 2 patients, early septic loosening in one patient and periprosthetic fracture in one patient.

Grade 1 notching was found in 17.9%, and acromion stress fracture was found in 3.6%. Three patients experienced postoperative neurological deficits, with complete recovery in 2 patients.

Conclusions

Compared with published data on stemmed and stemless rTSA, the comprehensive Nano rTSA system in the present study has comparable or even superior clinical outcomes at long-term follow-up. The rates of implant-associated complications and revision, however, are high compared with those reported in the literature.

Trial registration

Retrospectively registered on 6th August 2025 German Clinical Trial Register, clinical trial number DRKS00037624, https//www.drks.de/DRKS00037624.