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J Shoulder Elbow Surg. 2018 Apr;27(4):756-763. doi: 10.1016/j.jse.2017.08.020. Epub 2017 Oct 16.

Platform shoulder arthroplasty: a systematic review.

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MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA. Electronic address:
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Department of Orthopaedic Surgery, The Ohio State University, Columbus, OH, USA.
Department of Orthopaedic Surgery, St. Joseph Mercy Hospital, Ann Arbor, MI, USA.



Platform shoulder arthroplasty systems may allow conversion to a reverse total shoulder arthroplasty (RTSA) without removing a well-fixed, well-positioned humeral stem. We sought to evaluate the complications associated with humeral stem exchange versus retention in patients undergoing conversion shoulder arthroplasty with a platform shoulder arthroplasty system.


PubMed, MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Embase were searched from database inception through October 9, 2016, for all articles comparing humeral stem retention versus exchange during conversion RTSA or that pertained to conversion RTSA with stem retention alone. All studies were screened in duplicate for eligibility. A methodologic quality assessment was completed for included studies. Pooled outcomes assessing complications, operative time, blood loss, and reoperations were determined.


We included 7 studies (236 shoulders), including 1 level III and 6 level IV studies. Pooled analysis demonstrated significantly higher overall complications (odds ratio, 6.89; 95% confidence interval [CI], 2.48-19.13; P = .0002), fractures (odds ratio, 4.62; 95% CI, 1.14-18.67; P = .03), operative time (mean difference, 62.09 minutes; 95% CI, 51.17-73.01 minutes; P < .00001), and blood loss (mean difference, 260.06 mL; 95% CI, 165.30-354.83 mL; P < .00001) with humeral stem exchange. Stem exchange was also associated with increased risk of reoperation (P = .0437).


Conversion arthroplasty with retention of the humeral stem is associated with lower overall complications, blood loss, operative time, and reoperations in comparison with stem exchange.


Platform arthroplasty; conversion shoulder arthroplasty; convertible arthroplasty; modular arthroplasty; reverse total shoulder arthroplasty; shoulder; total shoulder arthroplasty

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