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Journal of Shoulder and Elbow Surgery

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https://www.readbyqxmd.com/read/27908742/arthroscopic-arthrodesis-of-the-shoulder-in-brachial-plexus-palsy
#1
Hubert Lenoir, Thomas Williams, Aude Griffart, Cyril Lazerges, Michel Chammas, Bertrand Coulet, Dominique Le Nen
BACKGROUND: Shoulder arthroscopic arthrodesis is an uncommon and non-standardized procedure. Results are poorly evaluated. We describe the findings in 8 patients who underwent shoulder arthroscopic arthrodesis for brachial plexus injury. METHODS: The humeral head and glenoid were excised through standard arthroscopic portals. A Hoffmann external fixator and cannulated screws were used to stabilize the shoulder. Standard clinical assessment and radiographic evaluation were performed each month until bony fusion occurred...
November 28, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27887875/two-stage-revision-for-infected-shoulder-arthroplasty
#2
Daniel B Buchalter, Siddharth A Mahure, Brent Mollon, Stephen Yu, Young W Kwon, Joseph D Zuckerman
BACKGROUND: Periprosthetic shoulder infections (PSIs) are challenging to treat and often result in significant patient morbidity. Without a standardized treatment protocol, PSIs are often managed similarly to periprosthetic hip and knee infections. Because 2-stage revision is the gold standard for treating periprosthetic hip and knee infections, we performed a case series and literature review to determine its effectiveness in PSIs. METHODS: We identified 19 patients (14 men) from our institution who were treated with a 2-stage revision after presenting with a PSI...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27887874/clinical-and-radiographic-outcome-of-revision-surgery-of-radial-head-prostheses-midterm-results-in-16-patients
#3
Jetske Viveen, Izaäk F Kodde, Koen L M Koenraadt, Annechien Beumer, Bertram The, Denise Eygendaal
BACKGROUND: Little is known about revision surgery of radial head arthroplasty. The aim of this study was to report on the clinical and radiographic outcome of revision arthroplasty of the elbow with a bipolar metallic radial head prosthesis. METHODS: Between 2006 and 2013, we used either a press-fit or cemented RHS bipolar radial head prosthesis for revision surgery of radial head arthroplasty in 16 patients. Patients were prospectively enrolled in the study. Differences in outcome parameters before and after revision surgery were compared...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27887873/a-rapid-method-for-detecting-propionibacterium-acnes-in-surgical-biopsy-specimens-from-the-shoulder
#4
Scott Holmes, Ana M Pena Diaz, George S Athwal, Kenneth J Faber, David B O'Gorman
BACKGROUND: Propionibacterium (P) acnes infection of the shoulder after arthroplasty is a common and serious complication. Current detection methods for P acnes involve anaerobic cultures that require prolonged incubation periods (typically 7-14 days). We have developed a polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) approach that sensitively and specifically identifies P acnes in tissue specimens within a 24-hour period. METHODS: Primers were designed to amplify a unique region of the 16S rRNA gene in P acnes that contained a unique HaeIII restriction enzyme site...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27887872/optimizing-the-rehabilitation-of-elbow-lateral-collateral-ligament-injuries-a-biomechanical-study
#5
Ranita H K Manocha, Jonathan R Kusins, James A Johnson, Graham J W King
BACKGROUND: Elbow lateral collateral ligament (LCL) injury may arise after trauma or lateral surgical approaches. The optimal method of rehabilitating the LCL-insufficient elbow is unclear. Therapists often prescribe active motion exercises with the forearm pronated. Recently, overhead exercises have become popular as they may enable gravity to compress the elbow joint, improving stability, although this has not been proved biomechanically. This investigation aimed to quantify the effects of several variables used in LCL injury rehabilitation on elbow stability...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27887871/radiographic-results-of-augmented-all-polyethylene-glenoids-in-the-presence-of-posterior-glenoid-bone-loss-during-total-shoulder-arthroplasty
#6
Scott P Stephens, Edwin E Spencer, Michael A Wirth
BACKGROUND: Chronic osteoarthritis can result in glenohumeral subluxation and loss of posterior glenoid bone. This can alter normal glenohumeral biomechanics and affect the stress placed on the glenoid implant after total shoulder arthroplasty. This study evaluated the clinical and radiographic results of an augmented all-polyethylene glenoid for the treatment of glenoid osteoarthritis in the presence of posterior glenoid bone loss and determined whether any failures or complications occurred with short-term follow-up...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27887870/involvement-of-indian-hedgehog-signaling-in-mesenchymal-stem-cell-augmented-rotator-cuff-tendon-repair-in-an-athymic-rat-model
#7
Jian-Chun Zong, Michael J Mosca, Ryan M Degen, Amir Lebaschi, Camila Carballo, Andrew Carbone, Guang-Ting Cong, Liang Ying, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Bone marrow aspirate has been used in recent years to augment tendon-to-bone healing, including in rotator cuff repair. However, the healing mechanism in cell-based therapy has not been elucidated in detail. METHODS: Sixteen athymic nude rats were randomly allocated to 2 groups: experimental (human mesenchymal stem cells in fibrin glue carrier) and control (fibrin glue only). Animals were sacrificed at 2 and 4 weeks. Immunohistochemical staining was performed to evaluate Indian hedgehog (Ihh) signaling and SOX9 signaling in the healing enthesis...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27881294/comparison-of-outcomes-with-arthroscopic-repair-of-acute-on-chronic-within-6-months-and-chronic-rotator-cuff-tears
#8
Jeung Yeol Jeong, Seung Yeop Song, Jae Chul Yoo, Keun Min Park, Sang Min Lee
BACKGROUND: The purpose of this study was to define preoperative and intraoperative findings of acute-on-chronic rotator cuff tears (RCTs). This study also compared the functional and clinical outcomes with acute-on-chronic RCTs and chronic RCTs. METHODS: This study was conducted between December 2007 and December 2013. An acute-on-chronic full-thickness RCT was diagnosed with preoperative and intraoperative findings on arthroscopy. The study group consisted of 36 patients with preoperative and intraoperative findings (surgery performed within 6 months of trauma) indicative of an acute-on-chronic RCT...
November 21, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27876362/boxer-s-elbow-internal-impingement-of-the-coronoid-and-olecranon-process-a-report-of-seven-cases
#9
Paul M Robinson, Mike Loosemore, Adam C Watts
BACKGROUND: Boxer's elbow has been described in the literature as an extension and hyperextension injury. However, in our experience, there is a coexisting impingement lesion in the anterior compartment of the elbow that has not previously been described. We report a series of professional boxers with elbow disease treated arthroscopically. The aim of the paper was to accurately describe the pathoanatomy of the condition, the key points in its diagnosis, and the outcomes of surgical treatment...
November 18, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27863927/concomitant-injury-of-the-annular-ligament-in-fractures-of-the-coronoid-process-and-the-supinator-crest
#10
Tim Leschinger, Lars Peter Müller, Michael Hackl, Martin Scaal, Kay Schmidt-Horlohé, Kilian Wegmann
BACKGROUND: Fractures of the coronoid process or the supinator crest, as well as arthroscopic resection of osteophytes around the coronoid process, can endanger the attachment of the annular ligament (AL) to the proximal ulna. The purpose of this study was to investigate the corresponding insertional areas of the AL within this context. METHODS: In 30 embalmed human cadaveric elbow specimens, the insertional area of the AL at the anterior and posterior margin of the sigmoid notch was characterized...
November 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27856267/is-the-stemless-humeral-head-replacement-clinically-and-radiographically-a-secure-equivalent-to-standard-stem-humeral-head-replacement-in-the-long-term-follow-up-a-prospective-randomized-trial
#11
Stephan Uschok, Petra Magosch, Merethe Moe, Sven Lichtenberg, Peter Habermeyer
BACKGROUND: Stemless humeral head replacement represents a young generation of shoulder arthroplasty. This study evaluated the differences of this new stemless design compared with the fourth-generation standard stemmed design. METHODS: Total shoulder arthroplasty was performed in 20 patients with a stemless shoulder prosthesis (group 1) and in 20 patients with a standard stem humeral head replacement (group 2). Twenty-nine patients were examined clinically and radiographically at a minimum follow-up of 2 years and a minimum follow-up of 5 years...
November 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27856266/local-injection-of-liposomal-bupivacaine-combined-with-intravenous-dexamethasone-reduces-postoperative-pain-and-hospital-stay-after-shoulder-arthroplasty
#12
Howard D Routman, Logan R Israel, Molly A Moor, Andrew D Boltuch
BACKGROUND: Alternative techniques have been developed to address pain after shoulder arthroplasty and are well documented. We evaluated the effect of adding intraoperative liposomal bupivacaine and intravenous dexamethasone during shoulder arthroplasty. METHODS: We retrospectively reviewed 2 consecutive cohorts undergoing elective shoulder arthroplasty. The 24 patients in cohort 1 and the 31 patients in cohort 2 received perioperative multimodal management with preoperative and postoperative intravenous and oral narcotics, gabapentin, nonsteroidal anti-inflammatory drugs, acetaminophen, and single-injection interscalene block...
November 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27856265/bilateral-reverse-total-shoulder-arthroplasty-functional-outcome-and-activities-of-daily-living
#13
Ofer Levy, Joanna Walecka, George Arealis, Oren Tsvieli, Giuseppe Della Rotonda, Ruben Abraham, Ioannis Polyzois, Zac Jurkowski, Ehud Atoun
BACKGROUND: Reverse total shoulder arthroplasty (rTSA) has gained popularity in recent years, providing good shoulder elevation, yet less predictable rotations. Good rotations are crucial for performance of activities of daily living (ADLs), including personal hygiene. Concerns remain regarding bilateral rTSA over lack of rotations bilaterally and resultant difficulties with ADLs. This study examined the outcome of patients with bilateral rTSA in restoration of function and ADLs. METHODS: Data were prospectively collected for 19 patients (15 women, 4 men; 38 shoulders), with a mean age of 74...
November 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27856264/glenohumeral-arthrodesis-for-recurrent-types-ii-and-iii-shoulder-instability
#14
Tanujan Thangarajah, Deborah Higgs, J Ian L Bayley, Simon M Lambert
BACKGROUND: This study reports the clinical outcome after glenohumeral arthrodesis for recurrent type II (atraumatic structural) and type III (muscle patterning nonstructural disorder) shoulder instability. METHODS: A retrospective review was conducted at a single facility. Eight consecutive patients (7 women and 1 man) with recurrent shoulder instability underwent arthrodesis and were monitored for a mean of 57 months (range, 24-123 months). Mean age at the time of surgery was 47 years (range, 21-73 years)...
November 15, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27814945/reconstruction-of-medial-collateral-ligament-defects-with-a-flexor-pronator-fascia-patch-in-complete-open-release-of-stiff-elbows
#15
Shuai Chen, Hede Yan, Wei Wang, Mei Zhang, Kevin A Hildebrand, Cun-Yi Fan
BACKGROUND: Because medial elbow stability is essential for stiff elbow release, surgical techniques have been reported for reconstructing medial elbow stability. However, medial collateral ligament (MCL) defects, caused by inevitable detachment and resection performed for complete release, make the reconstruction more challenging. To our knowledge, no study has evaluated the outcomes after using a flexor-pronator fascia patch in medial elbow reconstruction for open release of stiff elbows...
November 2, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27814944/correlations-of-coracohumeral-ligament-and-range-of-motion-restriction-in-patients-with-recurrent-anterior-glenohumeral-instability-evaluated-by-magnetic-resonance-arthrography
#16
Kenji Kanazawa, Yoshihiro Hagiwara, Nobuaki Kawai, Takuya Sekiguchi, Masashi Koide, Akira Ando, Hiroyuki Sugaya, Eiji Itoi
BACKGROUND: Evaluation of range of motion (ROM) restriction before treatment of shoulder disorders is important for predicting the final functional outcomes. The purpose of this study was to investigate correlations of thickness of the coracohumeral ligament (CHL) and ROM restriction in patients with recurrent anterior glenohumeral instability. METHODS: Between January 2005 and March 2015, 181 shoulders (137 male and 44 female patients; mean age, 29.3 years) with recurrent anterior glenohumeral instability treated with an arthroscopic Bankart repair were enrolled in this study...
November 2, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27810265/effect-of-smoking-on-complications-following-primary-shoulder-arthroplasty
#17
Taku Hatta, Jean-David Werthel, Eric R Wagner, Eiji Itoi, Scott P Steinmann, Robert H Cofield, John W Sperling
BACKGROUND: The purpose of this study was to examine the effect of smoking on the incidence of complications after primary anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). METHODS: All patients who underwent primary TSA or RSA at our institution between 2002 and 2011 and had a minimum 2-year follow-up were included. Smoking status was assessed at the time of surgery. Current smokers, former smokers, and nonsmokers were compared for periprosthetic infection, fractures (intraoperative and postoperative), and loosening after surgery...
October 31, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27810264/the-nirschl-procedure-versus-arthroscopic-extensor-carpi-radialis-brevis-debridement-for-lateral-epicondylitis
#18
Bong Cheol Kwon, Jin Young Kim, Kun-Tae Park
BACKGROUND: The Nirschl technique and arthroscopic debridement are common surgical procedures for chronic lateral elbow tendinopathy. The purpose of this study was to compare outcomes following the use of these techniques to treat chronic lateral elbow tendinopathy. METHODS: We retrospectively reviewed 59 elbows of 55 patients who did not improve after conservative treatment. Twenty-nine elbows of 26 patients were treated with the Nirschl procedure (Nirschl group), and 30 elbows of 29 patients were treated with arthroscopic debridement (arthroscopy group)...
October 31, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27771263/clinical-efficacy-of-hydrodistention-with-joint-manipulation-under-interscalene-block-compared-with-intra-articular-corticosteroid-injection-for-frozen-shoulder-a-prospective-randomized-controlled-study
#19
Sang Won Mun, Chang Hee Baek
BACKGROUND: Hydrodistention is known to be an effective method of treatment for frozen shoulder. However, hydrodistention is accompanied by severe pain during the procedure. An interscalene block may relieve the severe pain associated with the procedure of hydrodistention. This study compared the clinical efficacy of hydrodistention with joint manipulation under an interscalene block with that of intra-articular corticosteroid injection. METHODS: This prospective randomized controlled study included 121 patients presenting with frozen shoulder...
October 19, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27765502/generic-targeting-guides-place-revision-glenoid-components-in-more-anatomic-version-than-traditional-techniques
#20
Ryan P Mulligan, Frederick M Azar, Thomas W Throckmorton
BACKGROUND: Glenoid component positioning in revision shoulder arthroplasty is difficult because of distorted anatomic landmarks and scarring in and around the glenoid vault. This study compared glenoid component version in revision total shoulder arthroplasty (TSA) and reverse TSA (RTSA) using traditional instrumentation vs. a generic glenoid targeting guide. METHODS: Radiographs of 50 shoulders undergoing revision arthroplasty were reviewed by an independent reviewer...
October 17, 2016: Journal of Shoulder and Elbow Surgery
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