In the United States, stemless total shoulder arthroplasty (TSA) was approved in 2015, although there was still a lack of evidence on its performance in this market. Reduced operational time without compromising clinical results is a possible benefit of stemless TSA, although no comparative trials have been conducted too far. The surgical timeframes and clinical effects of stemless vs. traditional stemmed TSA are compared in this study. This retrospective cohort research looks at all TSAs performed by a single surgeon from 2015 to 2018. Data was gathered from 59 patients who had TSA with traditional, stemmed humeral implants and 115 patients who had TSA with a stemless humeral implant. Patient-reported outcome measures (PROMs) were obtained prospectively by the study group from the Surgical Outcomes System (SOS) database. In addition, they retrospectively collected operational times and demographic data from the anesthetic record. 

Visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and Single Assessment Numerical Evaluation (SANE) scores were serially recorded for PROMs until a minimum 2-year follow-up was completed. The stemless cohort required 24 minutes less operational time than the stemmed cohort (104 minutes vs. 128 minutes, P<0.001). The cost study revealed a 15.9% reduction in human costs, resulting in a 3.1% reduction in OR-related expenses. In both cohorts, patient-reported outcome scores improved considerably after surgery at all periods. At the two-year follow-up, there was no difference in VAS, ASES, or SANE ratings between the cohorts. At least two years after surgery, stemless TSA considerably lowers operating time while maintaining functional outcomes.