OTSR - 2026-07-10 - Journal Article; Review
Long-term results of the stemless TESS prosthesis in anatomic shoulder arthroplasty.
Teissier P, Werthel JD, Cloquell Y, Bouhali H, Toffoli A, Degeorge B, Teissier J
Topics
Key Takeaway
Stemless TESS anatomic shoulder arthroplasty achieved a mean Constant-Murley score improvement from 29 to 72 points at mean 134-month follow-up with zero humeral component loosening despite frequent peripheral radiolucent lines in zones 1 and 5.
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Summary
This prospective consecutive case series evaluated functional and radiographic outcomes of the stemless TESS humeral implant in 48 anatomic shoulder arthroplasties performed 2005–2008. Constant-Murley scores improved from 29 to 72 at mean 134-month follow-up. Radiolucent lines were common at the peripheral humeral rim (zones 1 and 5) but no cases of humeral loosening were identified.
Key Limitation
Absence of glenoid component outcome data—including radiolucency, loosening, and revision rate—renders the study incomplete for assessing overall anatomic TSA durability, since glenoid failure is the primary driver of long-term revision.
Original Abstract
BACKGROUND
Shoulder osteoarthritis is common and results in pain and loss of function. The goal of surgery is typically less pain and improved function. The design of anatomic prostheses has improved from the first generation in the 1950s with the Neer I, to modular components. In 2005, the first stemless shoulder prosthesis, the Total Evolutive Shoulder System (TESS; Biomet France, Valence, France), was launched. It was designed to be as minimally invasive as possible to save bone stock. Previous studies showed good short and medium-term results with all anatomic stemless shoulder implants. This paper reports the 10-year follow-up results.
METHODS
This study was a prospective consecutive case series. From 2005 to 2008, 48 cases underwent implantation with an anatomical stemless TESS. Functional outcomes and radiological results were studied, specifically looking for bone modifications and loosening.
RESULTS
At a mean follow-up of 134 months, functional outcomes improved significantly, from 29 to 72 points on the Constant-Murley scale. Radiolucent lines were frequent in the peripheral rim of the humeral side, in zones 1 and 5. There was no humeral loosening.
CONCLUSION
Stemless TESS implantation provided good functional and radiological outcomes at 10-year follow-up. Minimally invasive stemless humeral implants can be used with confidence for anatomic arthroplasties.
LEVEL OF EVIDENCE
IV; cases series, treatment study.