ReUnion® SHumeral Stem

Bone preservation. Alignment. Stability.

ReUnion S Shoulder System

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Standard stems legacy

Shoulder arthroplasty has become an impactful procedure in managing severe shoulder pathologies.

Implant design, materials and instrumentation have enhanced over the past five decades. We have seen shifts in complications with hemi, total and reverse shoulder arthroplasty over the years as well. What has been fairly consistent is low post-operative complications with traditional length humeral stems.1,2

Current U.S. landscape

2006 201320122010200920082007 2011

Biomet Mini Wright Tornier Ascend Flex

Wright Tornier Ascend

ReUnion TSA

150,000 projected shoulder replacement surgeries in the U.S. during 20193

ReUnion S Shoulder System

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The need for short stems

Since 2006, many humeral stems have entered the market. With varying lengths, geometries and coatings, the perceived benefit has driven the market to adopt a newer stem design.

Each year, with more patients struggling with severe shoulder pain and arthritis in the US, the question arises as to which treatment option is appropriate for their condition.4

2019201820172016201520142013

Arthrex Apex DJO AltiVate Anatomical Exactech Preserve

ReUnion SReUnion RFXReUnion RSA

Bone preservation • Simplicity of the procedure • Potential of revision surgery

ReUnion S Shoulder System

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Unforeseen issues in comparison to standard stems

With the addition of these new stems, some systems have unfortunately experienced unforeseen issues inherent with the design of their implants.5 By trying to preserve bone distally and limit intra-operative challenges, new complications are presenting.

The issue…• Humeral loosening1,4

• More proximal bone removed5

• Proximal bone resorption6

• Cortical thinning6

• Calcar osteolysis6

Can be caused by…• Higher proximal bulk – less bone preserved in the metaphysis5

• Stress shielding6

• No bony apposition1,5

Standard length stem2-year post operative radiograph

Shorter length stem

ReUnion S Shoulder System

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How did SOMA find the ideal length?

The Stryker Orthopaedics Modeling and Analytics (SOMA) technology, is Stryker’s proprietary database of 3D CTA Scans and software. Today, over 19,500 bones from all ethnicities are in the SOMA database, allowing for the design of a better fitting implant.

SOMA

1. SOMA analyzed the shape and size of 272 humeri.

2. A minimum point of 67.5mm from the resection plane is noted as what is needed to begin achieving proper stem alignment.

3. The distal alignment point is 16mm beyond the transition point intended to optimize initial implant stability.

4. The effective minimum length of ReUnion S is 83.5mm. By using SOMA, ReUnion S is the ideal length stem.

Data driven length

We turned to science to design the ideal length stem.7 The geometry of the intramedullary canal and its relationship to the length and diameter of the humeral bone was analyzed using SOMA.

67.5mm

16mm

83.5mmDistal alignment point

Transition point

Transition point: minimum point at which stem alignment begins

Distal alignment point: minimum point a stem needs to hit for stable alignment

ReUnion S Shoulder System

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Implanting confidently with ReUnion S

Designed to be the ideal length

Bone preservation1

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Bone preservation: Reduced stem length was determined through our SOMA analysis; identifying a humeral transition point and alignment length. By keeping the wedge shape proximal body, soft tissue management preference is that of the user, not limited by the stem design.7

AlignmentWith the transition point identified, our target alignment zone was identified to avoid varus/valgus placement of the stem.5,7

StabilityThe S stem is designed to retain the alignment and stability benefits of a longer humeral stem prosthesis. The enhanced medial sweep of the stem avoids distal engagement while the alignment focused length and incremental distal sizing options prevent canal migration.7

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The ReUnion S stem is designed to be the ideal length stem, optimizing bone preservation, alignment, and stability.7

ReUnion S Shoulder System

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References

1. Gilot G, Alcareaz-Pinzon AM, Wright TW, Flurin PH, Krill M, Routman HD, Zuckerman JD. The incidence of radiographic aseptic loosening of the humeral component in reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2015 Oct;24(10):1555-9. Epub 2015 May 7

2. Deshmukh et al., Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg 2005;14:471-479.

3. SmartTrak 2019 US Shoulder Market Data

4. Morwood MP, Johnston PS, Garrigues GE. Proximal ingrowth coating decreases risk of loosening following uncemented shoulder arthroplasty using mini-stem humeral components and lesser tuberosity osteotomy. J Shoulder Elbow Surg 2017;26:1246-52

5. Raiss et al., Postoperative radiographic findings of an uncemented convertible short stem for anatomic and reverse shoulder arthroplasty, Journal of Shoulder and Elbow Surgery, 2018

6. Casagrande et al., Radiographic evaluation of short-stem press-fit total shoulder arthroplasty: short- term follow-up. J Shoulder Elbow Surg, 2016;25:1163-9.

7. RU-WP-3: Analysis of humeral morphology as it relates to stem length

ReUnion® PlatformImplanting with confidence.

A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery. The information presented is intended to demonstrate the breadth of Stryker product offerings. A surgeon must always refer to the package insert, product label and/or instructions for use before using any Stryker product. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: ReUnion, SOMA, Stryker. All other trademarks are trademarks of their respective owners or holders.

Content ID: RU-BR-2, 05-2019 Copyright © 2019 Stryker

Trauma & Extremities