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Journal of Shoulder and Elbow Surgery

Toni Luokkala, David Temperley, Subhasis Basu, Teemu V Karjalainen, Adam C Watts
BACKGROUND: The elbow is the second most commonly dislocated joint. Stability depends on the degree of soft tissue injury, with 2 proposed patterns, one starting laterally and the other medially. The purpose of this study was to describe the injured structures observed in magnetic resonance images (MRIs) in a prospective cohort of simple elbow dislocations. METHODS: We evaluated 17 consecutive cases of simple elbow dislocations. Two musculoskeletal radiologists assessed the initial x-ray images and MRIs performed for all elbows...
November 8, 2018: Journal of Shoulder and Elbow Surgery
Derek D Berglund, Dhanur Damodar, Rushabh M Vakharia, Ellie A Moeller, M Russell Giveans, Brandon Horn, Dragomir Mijic, Jonathan C Levy
BACKGROUND: The purpose of this study was to determine whether thresholds in the percentage of maximal improvement in the Simple Shoulder Test (SST) or American Shoulder and Elbow Surgeons (ASES) score exist for predicting "excellent" patient satisfaction after total shoulder arthroplasty (TSA). METHODS: A retrospective query identified patients who underwent TSA with a minimum of 2 years' follow-up. Preoperative and postoperative SST and ASES scores and postoperative patient satisfaction were recorded...
November 5, 2018: Journal of Shoulder and Elbow Surgery
Frederick A Matsen, Jeremy S Somerson, Jason E Hsu, Steven B Lippitt, Stacy M Russ, Moni B Neradilek
BACKGROUND: Cuff tear arthropathy is commonly managed with a reverse total shoulder arthroplasty (RTSA). A humeral hemiarthroplasty with an extended humeral head may provide a less invasive alternative for selected patients with cuff tear arthropathy if the shoulder has preserved active elevation. Because evidence regarding this procedure is limited, we investigated its safety and efficacy in treating selected patients with cuff tear arthropathy. METHODS: We analyzed the preoperative characteristics, surgical findings, and clinical outcomes for patients selected for extended head hemiarthroplasty...
November 2, 2018: Journal of Shoulder and Elbow Surgery
Michael P Reiman, Merritt D Walker, Scott Peters, Elizabeth Kilborn, Charles A Thigpen, Grant E Garrigues
BACKGROUND: Risk factors for ulnar collateral ligament injury (UCLI) are unclear despite increasing injury rates. We sought to summarize UCLI risk factors in baseball players. METHODS: A computer-assisted search of 4 databases was performed using keywords related to UCLI risk factors. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for study methodology. Odds ratios and 95% confidence intervals were calculated for dichotomous outcomes, and mean differences and 95% confidence intervals were calculated for continuous outcomes using a random-effects model...
November 1, 2018: Journal of Shoulder and Elbow Surgery
Mohammad Ghoraishian, Joseph A Abboud, Anthony A Romeo, Gerald R Williams, Surena Namdari
Glenoid bone loss and retroversion increase the complexity of primary shoulder arthroplasty and affect the outcome. Although eccentric reaming, augmented glenoid implants, bone grafting, and reverse arthroplasty have been used to manage bone loss and retroversion, there is no consensus on treatment. Posteriorly augmented glenoid components can correct retroversion and avoid joint line medialization, which occurs with corrective reaming techniques. Full-wedged, half-wedged, and stepped polyethylene posteriorly augmented designs are currently available for use in the United States...
November 1, 2018: Journal of Shoulder and Elbow Surgery
Jourdan M Cancienne, Michelle E Kew, Matthew J Deasey, Stephen F Brockmeier, Brian C Werner
BACKGROUND: The goals of the study were to determine (1) the incidence of dialysis patients undergoing shoulder arthroplasty (SA), (2) the association of dialysis modality with complications after SA, and (3) the association of dialysis dependence with death in patients undergoing SA and nonsurgical dialysis-dependent controls. METHODS: Using an insurance database, we identified dialysis-dependent patients undergoing SA and compared them with a matched control cohort without dialysis use...
November 1, 2018: Journal of Shoulder and Elbow Surgery
Paolo Arrigoni, Davide Cucchi, Alessandra Menon, Enrico Guerra, Simone Nicoletti, Alessandra Colozza, Francesco Luceri, Luigi Adriano Pederzini, Pietro Simone Randelli
BACKGROUND: This study investigated whether forearm movements change the relative position of the posterior interosseous nerve (PIN) with respect to the midline of the radial head (Rh) under direct arthroscopic observation. METHODS: The PIN was identified in 10 fresh frozen cadaveric specimens dissected under arthroscopy. The forearm was moved first in full pronation and then in full supination, and the displacement of the PIN from medial to lateral with respect to the midline of the Rh was recorded...
November 1, 2018: Journal of Shoulder and Elbow Surgery
Derek D Berglund, Dragomir Mijic, Tsun Yee Law, Jennifer Kurowicki, Samuel Rosas, Jonathan C Levy
BACKGROUND: Press-fit humeral fixation for reverse shoulder arthroplasty (RSA) has been shown to have loosening rates and outcomes similar to a cemented technique; however, increased value has not been reported. The purpose of this study was to determine whether the press-fit technique could improve the value of RSA using the procedure value index (PVI). METHODS: Primary RSA patients with complete hospitalization cost data, preoperative and minimum 2-year postoperative Simple Shoulder Test (SST) scores, and postoperative satisfaction were included...
November 1, 2018: Journal of Shoulder and Elbow Surgery
Valentin Rausch, Sebastian Wegmann, Michael Hackl, Tim Leschinger, Wolfram F Neiss, Martin Scaal, Lars P Müller, Kilian Wegmann
BACKGROUND: Acute injuries to the anterior medial collateral ligament (AMCL) can occur due to valgus trauma or during other dislocating events to the elbow. AMCL lesions are often associated with bony lesions, such as radial head fractures or fractures of the coronoid process. We analyzed the insertion of the AMCL on the sublime tubercle in relation to surrounding osseous structures. We aimed to increase the understanding of the involvement of the AMCL in bony lesions to the sublime tubercle...
October 31, 2018: Journal of Shoulder and Elbow Surgery
Pan Cai, Yang Yang, Zhengfeng Xu, Zhe Wang, Xiaoxiao Zhou, Tao Yang
BACKGROUND: Continued debate exists on the management of displaced 3- or 4-part proximal humeral fractures. Only a few studies have compared the efficacy of proximal humeral locking plates (PHLPs) for treating anatomic neck fractures (ANFs) and surgical neck fractures (SNFs). METHODS: The medical data of 31 consecutive patients with displaced 4-part proximal humeral fractures treated with PHLPs between May 2013 and April 2015 were reviewed retrospectively. We divided the patients into the ANF and SNF groups and assessed the neck-shaft angle (NSA), sum of the screw tip-articular surface distance, and other parameters postoperatively at 3 days and at 12 months using shoulder radiographs...
October 31, 2018: Journal of Shoulder and Elbow Surgery
Hao-Min Cui, Ya-Ling Yu, Yu He, Ling-Zhi Kong, Cun-Yi Fan
BACKGROUND: The purpose of our study was to evaluate the functional outcomes and oncologic results of elbow salvage surgery using arthrolysis combined with ligament repair and external fixation for reconstruction of the elbow after tumor excision and autografting. METHODS: We retrospectively reviewed 6 patients with elbow dysfunction associated with giant cell tumor of the distal humerus. All patients were treated with our combined protocol. We assessed the Musculoskeletal Tumor Society system score, range of motion, Mayo Elbow Performance Score, recurrence, and complications for each patient...
October 19, 2018: Journal of Shoulder and Elbow Surgery
Carolyn M Hettrich, Kevin J Cronin, Martin B Raynor, Emily Wagstrom, Sunil S Jani, James L Carey, Charles L Cox, Brian R Wolf, John E Kuhn
HYPOTHESIS: The purpose of this multicenter epidemiologic study was to determine the distribution of patients within the Frequency, Etiology, Direction, and Severity (FEDS) classification system to determine which categories are of clinical importance. METHODS: Shoulder instability patients were identified using International Classification of Diseases, Ninth Revision coding data from 3 separate institutions from 2005-2010. Data were collected retrospectively. Details of instability were recorded in accordance with the FEDS classification system...
October 19, 2018: Journal of Shoulder and Elbow Surgery
Paul Hoogervorst, Anand Appalsamy, Diederik Meijer, Job N Doornberg, Albert van Kampen, Gerjon Hannink
BACKGROUND: Shortening of the fractured clavicle is proposed and debated as an indicator for surgical intervention. There is no standardized or uniform method for imaging and measuring shortening. Different methods and techniques can lead to different measured outcomes. However, the question remains whether a difference in measured shortening using a different technique has any short-term clinical relevance in terms of treatment strategy. The aim of this study was to investigate whether a different projection of the same midshaft clavicular fracture would lead to a different choice in treatment strategy...
October 19, 2018: Journal of Shoulder and Elbow Surgery
Matthieu Chivot, Damien Lami, Paul Bizzozero, Alexandre Galland, Jean-Noël Argenson
BACKGROUND: The objective of our study was to evaluate the results of surgical treatment by reverse shoulder arthroplasty (RSA) compared with nonsurgical treatment after 2 years of follow-up in patients aged 70 years or older with displaced 3-part or 4-part proximal humeral fractures. METHODS: Two groups were formed: the RSA group (n = 28) and the nonsurgical group (n = 32). Minimum follow-up was 2 years. We included patients with 3-part or 4-part fractures according to the Neer classification...
October 19, 2018: Journal of Shoulder and Elbow Surgery
Christian Spross, Wouter Jak, Roger P van Riet
BACKGROUND: The aim of this study was to analyze indications, outcomes, and complications in patients treated with radiocapitellar arthroplasty. METHODS: This prospective analysis of clinical and radiographic results included 16 elbows in 15 patients. RESULTS: This study included 4 men and 11 women (mean age, 51.9 years; age range, 32-65 years). The mean follow-up period was 3.4 years (range, 2-6 years). The indications were post-traumatic (n = 10) and primary radiohumeral osteoarthritis (n = 6)...
October 19, 2018: Journal of Shoulder and Elbow Surgery
Benjamin Strong, Michael Maloney, Judith Baumhauer, Joseph Schaffer, Jeff R Houck, Man Hung, Jerry Bounsanga, Maren W Voss, Yushan Gu, Ilya Voloshin
BACKGROUND: The Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Computer Adaptive Test (CAT) was previously validated for rotator cuff disease and shoulder instability. This study evaluated the psychometric properties of the PROMIS Physical Function (PF) CAT, PROMIS Pain Interference (PI) CAT, and the American Shoulder and Elbow Surgeons (ASES) Shoulder Function Score for subacromial impingement syndrome. METHODS: PROMIS PF CAT, PI CAT, and ASES (Pain, Function, Total) were collected on all visits for 2 surgeons between January 2016 and August 2016...
October 18, 2018: Journal of Shoulder and Elbow Surgery
Jens Nestorson, Hans Rahme, Lars Adolfsson
BACKGROUND: Primary prosthetic replacement has become an accepted method for the treatment of complex distal humeral fractures. The present study investigated implant survival and adverse events related to this procedure based on available Swedish registries and examined the completeness of the Swedish Elbow Arthroplasty register. MATERIALS AND METHODS: Patients treated in Sweden with a primary elbow replacement due to a distal humeral fracture between 1999 and 2014 were identified through 3 different registries: The Swedish Elbow Arthroplasty Register, National Board of Health and Welfare inpatient register, and local registries of all orthopedic departments...
October 17, 2018: Journal of Shoulder and Elbow Surgery
Kofi D Agyeman, Dhanur Damodar, Ian Watkins, Seth D Dodds
BACKGROUND: Radial head arthroplasty is used in the treatment of nonreconstructible radial head fractures. Although traditional implants have been loosely fixed, smooth stemmed implants functioning more as spacers, modern designs have introduced press-fit, tapered implants that articulate at the capitellum with more rigidly maintained congruity. Cemented implants also use rigid initial fixation. This study was conducted to help determine which fixation method results in better functional outcomes: "fixed" or "unfixed...
October 17, 2018: Journal of Shoulder and Elbow Surgery
Kirk M Thompson, Richard A Smith, Tyler J Brolin, Frederick M Azar, Thomas W Throckmorton
BACKGROUND: Postoperative pain control, short-term and long-term narcotic consumption, complication rates, and costs of indwelling interscalene catheter (ISC) were compared with a liposomal bupivacaine (LBC) mixture in patients undergoing primary total elbow arthroplasty. METHODS: Forty-four consecutive patients were identified, the first 28 with an ISC and the later 16 with intraoperative LBC injection that also included ketorolac and 0.5% bupivacaine. Medical records were reviewed for visual analog scale scores for pain, oral morphine equivalent (OME) use, complications, and facility charges...
October 16, 2018: Journal of Shoulder and Elbow Surgery
Jung-Taek Hwang, Youngbok Kim, Maegan N Shields, Daniel R Bachman, Lawrence J Berglund, Alessandro T Fitzsimmons, James S Fitzsimmons, Shawn W O'Driscoll
BACKGROUND: The interosseous membrane (IOM) and distal radioulnar joint (DRUJ) provide axial stability to the forearm. Our hypothesis was that injury to these structures alters force transmission through the elbow. METHODS: A custom-designed apparatus that applies axial loads from the wrist to the elbow was used to test 10 cadaveric upper limbs under the following simulated conditions (1) intact, (2) DRUJ injury, (3) IOM injury, or (4) IOM + DRUJ injury. IOM injury was simulated by osteotomies of the IOM attachment to the radius, and DRUJ injury was simulated by distal ulnar oblique osteotomy...
October 15, 2018: Journal of Shoulder and Elbow Surgery
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