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Journal of Shoulder and Elbow Surgery

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https://www.readbyqxmd.com/read/28751094/revision-of-failed-shoulder-hemiarthroplasty-to-reverse-total-arthroplasty-analysis-of-157-revision-implants
#1
Giovanni Merolla, Eric Wagner, John W Sperling, Paolo Paladini, Elisabetta Fabbri, Giuseppe Porcellini
BACKGROUND: There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. METHODS: A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28751093/two-stage-reimplantation-for-the-treatment-of-deep-infection-after-shoulder-arthroplasty
#2
Andrew T Assenmacher, Eduard Alentorn-Geli, Taylor Dennison, Yaser M K Baghdadi, Robert H Cofield, Joaquín Sánchez-Sotelo, John W Sperling
BACKGROUND: Two-stage reimplantation is the most common treatment modality considered for periprosthetic shoulder infection (PSI). Most studies to date have reported on a relatively small number of shoulders. The purpose of this study was to determine the outcome of 2-stage reimplantation for PSI in terms of both eradication of infection and restoration of function. METHODS: Between 1980 and 2010, 40 shoulders (39 patients) underwent a 2-stage reimplantation for PSI; 35 shoulders (34 patients) met inclusion criteria (10 hemiarthroplasties, 24 anatomic total shoulder arthroplasties, 1 reverse total shoulder arthroplasty)...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28751092/the-incidence-and-effect-of-fatty-atrophy-positive-tangent-sign-and-rotator-cuff-tears-on-outcomes-after-total-shoulder-arthroplasty
#3
W Stephen Choate, Ellen Shanley, Richard Washburn, Stefan J Tolan, Tariq I Salim, Josh Tadlock, Elizabeth C Shealy, Catherine D Long, Ashley E Crawford, Michael J Kissenberth, Keith T Lonergan, Richard J Hawkins, John M Tokish
BACKGROUND: Treatment choices for total shoulder arthroplasty (TSA) in the absence of full-thickness rotator cuff tears (RCTs) are not clearly defined in current literature. This study investigated the prevalence and effect of preoperative partial-thickness RCTs and muscular degenerative changes on postoperative outcomes after TSA. METHODS: Medical records and magnetic resonance imaging studies were reviewed for patients who underwent TSA for primary glenohumeral osteoarthritis with minimum 2-year follow-up to determine preoperative tear classification, Goutallier grade, and supraspinatus tangent sign...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28747277/glenosphere-size-in-reverse-shoulder-arthroplasty-is-larger-better-for-external-rotation-and-abduction-strength
#4
Andreas M Müller, Marian Born, Christian Jung, Matthias Flury, Christoph Kolling, Hans-Kaspar Schwyzer, Laurent Audigé
BACKGROUND: The role of glenosphere size in reverse shoulder arthroplasty (RSA) may be important in prosthetic stability, joint kinematics, rotator cuff tension and excursion, scapular impingement, humeral lateralization, deltoid wrap, and the occurrence of "notching." This study compared short- and midterm clinical and radiographic outcomes for 2 different glenosphere sizes of a single RSA type with respect to implant positioning, glenoid size, and morphology. METHODS: This retrospective analysis included 68 RSA procedures that were prospectively documented in a local register during a 5-year postoperative period...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28747276/tobacco-use-predicts-a-more-difficult-episode-of-care-after-anatomic-total-shoulder-arthroplasty
#5
Daniel B Wells, Andrew M Holt, Richard A Smith, Tyler J Brolin, Frederick M Azar, Thomas W Throckmorton
BACKGROUND: In the current health care environment, it is becoming increasingly important to recognize risks factors that may affect a patient's postoperative outcome. To determine the potential impact of tobacco as a risk factor, we evaluated postoperative pain, narcotic use, length of stay, reoperations, and complications in the global 90-day episode of care for patients undergoing anatomic total shoulder arthroplasty (TSA) who were current tobacco users, former users, or nonusers. METHODS: Database search identified 163 patients with primary anatomic TSA done for glenohumeral arthritis; these were divided into 3 groups: current tobacco users (28), nonusers (88), and former users (47)...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28747275/classifying-glenohumeral-synovitis-a-novel-intraoperative-scoring-system
#6
Daniel E Davis, Mitchell Maltenfort, Joseph A Abboud, Charles Getz
BACKGROUND: Synovitis of the shoulder is a common entity that is poorly described. This study aims to create a simple and reliable classification system for glenohumeral synovitis, which would benefit further research related to synovitis and outcomes. METHODS: Twenty 30-second shoulder arthroscopy videos were distributed to 19 fellowship-trained orthopedic surgeons. The observers responded with their years in practice, fellowship type, whether synovitis affects outcomes, and whether synovitis affects plans...
July 24, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28739300/the-critical-shoulder-angle-is-associated-with-osteoarthritis-in-the-shoulder-but-not-rotator-cuff-tears-a-retrospective-case-control-study
#7
Arnar O Bjarnison, Thomas J Sørensen, Thomas Kallemose, Kristoffer W Barfod
BACKGROUND: In 2013 Moor et al introduced the concept of the critical shoulder angle (CSA) and suggested that an abnormal CSA was a leading factor in development of rotator cuff tear (RCT) and osteoarthritis (OA) of the shoulder. This study assessed whether the CSA was associated with RCT and OA and tested the inter- and intrarater reliability of the CSA when measuring RCT and OA. MATERIALS AND METHODS: The study was performed as a retrospective case-control study...
July 21, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28739299/surgical-treatment-of-acute-type-v-acromioclavicular-joint-dislocations-in-professional-athletes-an-anatomic-ligament-reconstruction-with-synthetic-implant-augmentation
#8
Ioannis K Triantafyllopoulos, Kalliopi Lampropoulou-Adamidou, Nikitas P Schizas, Eleftherios V Karadimas
BACKGROUND: Most acromioclavicular (AC) joint injuries occur in men in their third decade of life during high-speed or high-impact body contact sports. The management of acute complete AC joint dislocation is surgical. Current surgical techniques include anatomic reconstruction of the main restraints of the AC joint and aim to improve functional outcomes and to reduce the complication rate. METHODS: We present 10 cases of acute type V AC joint dislocation in professional athletes treated surgically with anatomic reconstruction of the coracoclavicular and AC ligaments and augmentation with the use of a synthetic polyester tape...
July 21, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28739298/guidelines-for-humeral-subluxation-cutoff-values-a-comparative-study-between-conventional-reoriented-and-three-dimensional-computed-tomography-scans-of-healthy-shoulders
#9
Matthijs Jacxsens, Michael R Karns, Heath B Henninger, Alex J Drew, Alexander Van Tongel, Lieven De Wilde
BACKGROUND: The humeral subluxation index (HSI) is frequently assessed on computed tomography (CT) scans in conditions of the shoulder characterized by humeral displacement. An arbitrarily set HSI cutoff value of 45% for anterior subluxation and 55% for posterior subluxation has been widely accepted. We studied whether mean values and thresholds of humeral subluxation, in relation to the glenoid and scapula, were influenced by different imaging modalities. METHODS: The HSIs referenced to the scapula (SHSI) and glenoid (GHSI) were compared between conventional CT scans, CT scans reoriented into the corresponding reference plane (ie, scapular plane for the SHSI and glenoid center plane for the GHSI), and 3-dimensional (3D) CT reconstructions of 120 healthy shoulders...
July 21, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28739297/the-impact-of-insulin-dependence-on-short-term-postoperative-complications-in-diabetic-patients-undergoing-total-shoulder-arthroplasty
#10
Michael C Fu, Venkat Boddapati, David M Dines, Russell F Warren, Joshua S Dines, Lawrence V Gulotta
BACKGROUND: The number of total shoulder arthroplasty (TSA) procedures performed is steadily increasing, and it is important to characterize predictors of postoperative complications for risk assessment models. Whereas diabetes has been associated with increased morbidity after TSA, the impact of insulin dependence on the risk profile of diabetic patients has not been described. METHODS: The National Surgical Quality Improvement Program database from 2011-2014 was used to identify 5918 TSA cases...
July 21, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735848/the-outcomes-and-affecting-factors-after-arthroscopic-isolated-subscapularis-tendon-repair
#11
Yong Girl Rhee, Yeong Seok Lee, Yong Bok Park, Jung Youn Kim, Kwang Joon Han, Jae Chul Yoo
BACKGROUND: This study evaluated clinical outcomes for isolated subscapularis tendon tears treated by arthroscopic repair, the factors affecting clinical outcomes, and changes in tendon structural integrity using magnetic resonance imaging. METHODS: Between 2005 and 2013, 45 patients with isolated subscapularis tendon tears were enrolled from two institutions. Clinical outcomes were assessed using the pain visual analog scale, American Shoulder and Elbow Surgeons, and Simple Shoulder Test scores...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735847/transcutaneous-electrical-nerve-stimulation-for-postoperative-pain-relief-after-arthroscopic-rotator-cuff-repair-a-prospective-double-blinded-randomized-trial
#12
Siddharth A Mahure, Andrew S Rokito, Young W Kwon
BACKGROUND: Arthroscopic rotator cuff repair (ARCR) can be associated with significant postoperative pain. Concern for opioid abuse has led surgeons to identify alternative, efficacious methods of postoperative analgesia. To determine whether transcutaneous electrical nerve stimulation (TENS) can have a similarly beneficial effect after shoulder procedures, we conducted a prospective double-blinded randomized trial in patients undergoing outpatient ARCR. METHODS: All patients undergoing ARCR of a full-thickness rotator cuff tear by the senior authors were identified...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735846/gartland-types-iib-and-iii-supracondylar-fractures-of-the-humerus-in-children-is-blount-s-method-effective-and-safe
#13
Thuy-Trang Pham, Franck Accadbled, Abdelaziz Abid, Aissa Ibnoulkhatib, Xavier Bayle-Iniguez, Matthieu Wargny, Jérôme Sales de Gauzy
BACKGROUND: Blount's method is controversial for the treatment of Gartland types IIB and III supracondylar fracture of the humerus (SCFH) in children. The purpose of this study was to evaluate the clinical and radiologic outcomes and the failure and complication rates. METHODS: All types IIB and III SCFH treated with Blount's method from 2003-2013 were included in this retrospective single-center study. Clinical assessment was performed according to Flynn criteria...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735845/anterior-and-posterior-bands-of-the-anterior-bundle-in-the-elbow-ulnar-collateral-ligament-ultrasound-anatomy
#14
Masahito Yoshida, Hideyuki Goto, Tetsuya Takenaga, Atsushi Tsuchiya, Katsumasa Sugimoto, Volker Musahl, Freddie Fu, Takanobu Otsuka
BACKGROUND: The anterior oblique bundle (AOL) of the ulnar collateral ligament (UCL) is composed of anterior and posterior bands. This study evaluated the anatomy of the anterior and posterior bands in the AOL of the UCL for their separate visualization with ultrasound (US). METHODS: We dissected 18 cadaveric elbow joints and recorded the direction of each band from the lateral view to determine the proper position for the US transducer. To determine the proper inclination of the transducer, we measured the inclinations of each band at the proximal and distal insertions from the transverse view...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735844/hyperlipidemia-increases-the-risk-of-retear-after-arthroscopic-rotator-cuff-repair
#15
Grant H Garcia, Joseph N Liu, Alexandra Wong, Frank Cordasco, David M Dines, Joshua S Dines, Lawrence V Gulotta, Russell Warren
BACKGROUND: Hyperlipidemia (HL) has been identified as a risk factor for rotator cuff tear, but no studies have evaluated its effects on healing. The purpose of this study was to evaluate the effect of HL and statin use on rotator cuff healing after arthroscopic repair. METHODS: This was a retrospective review of 85 patients (86 shoulders) who underwent arthroscopic rotator cuff repair with postoperative ultrasound evaluation. Ultrasound findings were graded no retear, partial-thickness retear (PT), or full-thickness retear (FT)...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735843/does-arm-lengthening-affect-the-functional-outcome-in-onlay-reverse-shoulder-arthroplasty
#16
Birgit S Werner, Francesco Ascione, Giulia Bugelli, Gilles Walch
BACKGROUND: The concept of onlay design reverse shoulder arthroplasty has been introduced to overcome complications observed with the traditional Grammont-type prosthesis. The aim of this study was to determine the influence of arm lengthening on the short-term clinical outcome in onlay reverse shoulder arthroplasty and investigate the effect of humeral tray offset positioning on arm lengthening and range of motion. METHODS: We retrospectively evaluated 56 patients undergoing reverse shoulder arthroplasty with the Aequalis Ascend Flex prosthesis (Tornier, Bloomington, MN, USA) at a minimum 2 years' follow-up...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735842/angled-bio-rsa-bony-increased-offset-reverse-shoulder-arthroplasty-a-solution-for-the-management-glenoid-bone-loss-and-erosion
#17
Pascal Boileau, Nicolas Morin-Salvo, Marc-Olivier Gauci, Brian L Seeto, Peter N Chalmers, Nicolas Holzer, Gilles Walch
BACKGROUND: Glenoid deficiency and erosion (excessive retroversion/inclination) must be corrected in reverse shoulder arthroplasty (RSA) to avoid prosthetic notching or instability and to maximize function, range of motion, and prosthesis longevity. This study reports the results of RSA with an angled, autologous glenoid graft harvested from the humerus (angled BIO-RSA). METHODS: A trapezoidal bone graft, harvested from the humerus and fixed with a long-post baseplate and screws, was used to compensate for residual glenoid bone loss/erosion...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735841/the-perioperative-effects-of-chronic-preoperative-opioid-use-on-shoulder-arthroplasty-outcomes
#18
Jonathan W Cheah, David C Sing, Dell McLaughlin, Brian T Feeley, C Benjamin Ma, Alan L Zhang
HYPOTHESIS AND BACKGROUND: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. METHODS: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735840/critical-shoulder-angle-is-associated-with-full-thickness-rotator-cuff-tears-in-patients-with-glenohumeral-osteoarthritis
#19
Matthew T Mantell, Ryan Nelson, Jeremiah T Lowe, Donald P Endrizzi, Andrew Jawa
BACKGROUND: Higher critical shoulder angle (CSA) is correlated with rotator cuff tears (RCTs), whereas lower CSA is associated with glenohumeral osteoarthritis (OA). Our goal was to investigate whether patients with concurrent glenohumeral OA and full-thickness RCTs demonstrate a higher CSA than patients with OA alone. METHODS: Using a 2-surgeon shoulder arthroplasty registry, we identified 31 patients with glenohumeral OA and full-thickness RCTs confirmed by plain radiography and magnetic resonance imaging, respectively...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735839/epidemiology-of-proximal-humeral-fractures-a-detailed-survey-of-711-patients-in-a-metropolitan-area
#20
Daniele Passaretti, Vittorio Candela, Pasquale Sessa, Stefano Gumina
BACKGROUND: Literature lacks data concerning several epidemiologic aspects of proximal humeral fractures (PHFs). METHODS: This retrospective study included 711 consecutive patients (209 men, 502 women) who sustained a PHF in the last 3 years. Participants were divided into 2 groups, adults and children. Data regarding age, sex, date, and fracture side were collected. According to the mechanism of injury, we arbitrarily distinguished 7 subgroups. PHFs were classified according to the head-greater-lesser-shaft (HGLS)-Hertel classification and to the Salter-Harris classification using x-ray and computed tomography imaging...
July 20, 2017: Journal of Shoulder and Elbow Surgery
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