Assessment of intraoperative bleeding in reverse shoulder arthroplasty - with or without a stem.

Introduction: The functional results of stemless reverse shoulder prostheses are similar to those with stems. However, the operative time and the bleeding appear less significant because of the absence of humeral reaming. To date, the data amongst the literature regarding this subject is limited. Thus, we report a retrospective evaluation on these 2 types of prostheses by assessing their respective intraoperative blood loss.

Hypothesis: Reverse shoulder arthroplasty without a stem leads to less blood loss, compared to arthroplasty with a stem.

Materials And Methods: Twenty-three patients underwent an operation for a stemless prosthesis, while 37 patients had a prosthesis with a stem. The hemoglobin was measured preoperatively, as well as postoperatively. Drainage of the operative site was maintained for two to three days. In the stem group, the preoperative hemoglobin was 14g/dL (11.7-16.6), while it was 13.1g/dL (11-15.8) in the stemless group.

Results: The intraoperative bleeding reached 223cm (80-530), with an operative duration of 81minutes (40-110) in the stemless group, compared to 260cm (50-1000) and 92minutes (33-110) in the stem group. On the first day postoperatively, 333cm (20-570) of blood had been collected by drainage for the stemless group, compared to 279cm (40-550) in the stem group. The amount decreased the second day, with 139cm (20-510) and 129cm (0-750) respectively. There was no difference between the two groups regarding the postoperative hemoglobin level (11g/dL).

Discussion: There is no significant difference concerning the blood loss between reverse shoulder replacements with and without stems.

Level Of Evidence: III Retrospective case control study.