Short stems in anatomic shoulder replacement provide the advantage of avoiding the insertion of the stem at the curved area of the proximal humerus thus avoiding reaming of the cortices . This provides the theoretical advantage of protection of the cortical bone from from stress risers. In addition, the mismatch between the diaphyseal and metaphyseal area of the humerus is eliminated as the fixation is achieved in the metaphyseal area. It remains to be seen whether "distal fixation" is not necessary - at the tip of the stem, as this type of implant has no distal fixation. We use this stem in patients with good bone stock and no severe osteopenia with the idea that if future removal of the stem is required then revision surgery will be easier. In addition, the periprosthetic fracture below the stem should be less of a problem with this implant.
Szerlip BW, Morris BJ, Laughlin MS, Kilian CM, Edwards TB. Clinical and
radiographic outcomes after total shoulder arthroplasty with an anatomic
press-fit short stem. J Shoulder Elbow Surg. 2018 Jan;27(1):10-16.
