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https://www.readbyqxmd.com/read/28330420/arthroplasty-treatment-of-proximal-humerus-fractures-14-year-trends-in-the-united-states
#1
William W Schairer, Benedict U Nwachukwu, Stephen Lyman, Lawrence V Gulotta
OBJECTIVES: Proximal humerus fractures are a common injury in the elderly population that can usually be managed non-operatively. However, arthroplasty has become increasingly utilized for complex fractures and poor bone quality. We evaluated national trends in treatment, specifically looking at the adoption of reverse total shoulder arthroplasty. METHODS: The incidence of proximal humerus fractures was calculated from the Nationwide Emergency Department Database (NEDD) from 2006-2012...
March 22, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28304099/impact-of-shoulder-sonography-on-clinical-decision-making
#2
Michael V Friedman, Travis J Hillen, David V Holland, James M Essenberg, Jennifer L Demertzis
OBJECTIVES: To assess the impact of musculoskeletal shoulder sonography (US) on clinical decision making. METHODS: This Health Insurance Portability and Accountability Act-compliant retrospective study received Institutional Review Board approval with a waiver of informed consent. Consecutive musculoskeletal shoulder US examinations ordered over a 12-month period were retrospectively reviewed. The medical records of each patient were analyzed, recording immediate pre- and post-US treatment plans...
March 17, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28295125/treatment-of-locked-posterior-shoulder-dislocation-with-bone-defect
#3
Yousuf M Khira, Adel M Salama
Locked posterior shoulder dislocation is an uncommon condition and is associated with a reverse Hill-Sachs lesion in 50% of cases. The condition is likely to occur in cases of violent trauma, seizures, or electric shock. Unrecognized dislocation with humeral head fracture affects joint function and humeral head vascularity and may lead to chronic instability, osteonecrosis, and osteoarthritis. A group of 12 patients, including 10 men and 2 women, with neglected locked posterior shoulder dislocation with a reverse Hill-Sachs lesion were treated with the modified McLaughlin technique...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28292485/a-cost-effectiveness-analysis-of-reverse-total-shoulder-arthroplasty-versus-hemiarthroplasty-for-the-management-of-complex-proximal-humeral-fractures-in-the-elderly
#4
Georg Osterhoff, Nathan N O'Hara, Jennifer D'Cruz, Sheila A Sprague, Nick Bansback, Nathan Evaniew, Gerard P Slobogean
BACKGROUND: There is ongoing debate regarding the optimal surgical treatment of complex proximal humeral fractures in elderly patients. OBJECTIVES: To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) compared with hemiarthroplasty (HA) in the management of complex proximal humeral fractures, using a cost-utility analysis. METHODS: On the basis of data from published literature, a cost-utility analysis was conducted using decision tree and Markov modeling...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28291177/long-term-outcomes-of-reverse-total-shoulder-arthroplasty-a-follow-up-of-a-previous-study
#5
Guillaume Bacle, Laurent Nové-Josserand, Pascal Garaud, Gilles Walch
BACKGROUND: Despite the increasing numbers of reverse total shoulder arthroplasty (RTSA) procedures, the long-term results have been rarely reported. We previously reported early outcomes of a cohort of patients treated with a Grammont-style RTSA. The purpose of this study was to evaluate the outcomes after a minimum of 10 years, and to document prosthetic survival and complications. METHODS: Clinical outcome assessment was based on the absolute and relative Constant scores and the active range of motion...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28277259/comparison-of-reverse-total-shoulder-arthroplasty-outcomes-with-and-without-subscapularis-repair
#6
Richard J Friedman, Pierre-Henri Flurin, Thomas W Wright, Joseph D Zuckerman, Christopher P Roche
BACKGROUND: Repair of the subscapularis with reverse total shoulder arthroplasty (rTSA) is controversial. The purpose of this study is to quantify rTSA outcomes in patients with and without subscapularis repair to determine if there is any impact on clinical outcomes. METHODS: Three hundred forty patients received rTSA and had the subscapularis repaired, whereas 251 patients received rTSA and did not have the subscapularis repaired. The patients were scored preoperatively and at latest follow-up using the Simple Shoulder Test; University of California, Los Angeles; American Shoulder and Elbow Surgeons; Constant; and Shoulder Pain and Disability Index metrics...
October 27, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28274706/increased-joint-pain-after-massive-weight-loss-is-there-an-association-with-joint-hypermobility
#7
Monika Fagevik Olsén, Sofie Brunnegård, Sofia Sjöström, Christina Biörserud, Gunilla Kjellby-Wendt
BACKGROUND: Obesity is associated with an increased risk of pain in weight-bearing joints. Although pain often decreases after obesity surgery, this is the reverse for some patients. Hypermobility is described as an excessive range of motion in joints and has been suggested to be a possible cause of joint pain. It is not known whether there is an association between increased joint pain after weight loss and hypermobility. OBJECTIVES: The objective of this study was to investigate whether there is an association between hypermobility and increased joint pain after massive weight loss...
January 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28261432/comparison-of-clinical-and-radiological-results-according-to-glenosphere-position-in-reverse-total-shoulder-arthroplasty-a-short-term-follow-up-study
#8
Chang Hyuk Choi, Sung Guk Kim, Jae Jun Lee, Byung Hoon Kwack
BACKGROUND: In a previous biomechanical study, eccentric glenospheres with more inferior position of the center of rotation were shown to improve range of motion and reduce the incidence of scapular notching after reverse total shoulder arthroplasty (RSA). The purpose of this study was to compare the clinical and radiological results of RSA using an eccentric glenosphere to those using a concentric glenosphere and to determine the usefulness of the eccentric glenosphere. METHODS: From 2009 to 2015, we performed a retrospective review of 20 consecutive patients who underwent RSA using a deltopectoral approach...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28256437/the-main-cause-of-instability-after-unconstrained-shoulder-prosthesis-is-soft-tissue-deficiency
#9
Jean Kany, Jijo Jose, Denis Katz, Jean David Werthel, Padmanaban Sekaran, Rajkumar S Amaravathi, Philippe Valenti
BACKGROUND: Instability is one of the major causes of failures in unconstrained anatomic total shoulder arthroplasty (TSA). This study reviewed the instabilities that may occur in an anatomic shoulder platform system to identify its potential predictors. We hypothesized that soft tissue deficiency was the main cause of instability and that the best treatment option would be conversion to a reverse shoulder arthroplasty (RSA). MATERIALS AND METHODS: Between 2003 and 2013, we reviewed 27 patients who experienced postoperative instability, and the overall incidence was 5...
February 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28245852/reverse-shoulder-arthroplasty-for-the-treatment-of-proximal-humeral-fractures-in-the-elderly-reshape-trial-study-protocol-for-a-multicentre-combined-randomised-controlled-and-observational-trial
#10
Geoffrey C S Smith, Ed Bateman, Ben Cass, Maurizio Damiani, Wade Harper, Hugh Jones, David Lieu, Jeff Petchell, Minas Petrelis, Kalman Piper, Doron Sher, Christopher J Smithers, John Trantalis, Sindy Vrancic, Ian A Harris
BACKGROUND: Proximal humeral fractures are common in older patients. The majority are minimally displaced and are associated with good outcomes after nonoperative treatment. Poorer outcomes are associated with displaced, multipart fractures. There is no clear benefit from surgical fracture fixation compared to nonoperative treatment. Replacement of the fractured humeral head with a hemiarthroplasty is another treatment option, but has not been shown to be clearly superior to nonoperative treatment or internal fixation...
February 28, 2017: Trials
https://www.readbyqxmd.com/read/28217660/reverse-total-shoulder-arthroplasty-research-models
#11
Stefano Petrillo, Umile Giuseppe Longo, Lawrence V Gulotta, Alessandra Berton, Andreas Kontaxis, Timothy Wright, Vincenzo Denaro
PURPOSE: the past decade has seen a considerable increase in the use of research models to study reverse total shoulder arthroplasty (RTSA). Nevertheless, none of these models has been shown to completely reflect real in vivo conditions. METHODS: we performed a systematic review of the literature matching the following key words: "reverse total shoulder arthroplasty" or "reverse total shoulder replacement" or "reverse total shoulder prosthesis" and "research models" or "biomechanical models" or "physical simulators" or "virtual simulators"...
October 2016: Joints
https://www.readbyqxmd.com/read/28205145/is-reverse-total-shoulder-arthroplasty-a-feasible-treatment-option-for-failed-shoulder-arthroplasty-a-retrospective-study-of-44-cases-with-special-regards-to-stemless-and-stemmed-primary-implants
#12
M Holschen, B Franetzki, K-A Witt, D Liem, J Steinbeck
Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants. BACKGROUND: Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants...
February 15, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28190669/insurance-status-affects-postoperative-morbidity-and-complication-rate-after-shoulder-arthroplasty
#13
Xinning Li, David R Veltre, Antonio Cusano, Paul Yi, David Sing, Joel J Gagnier, Josef K Eichinger, Andrew Jawa, Asheesh Bedi
BACKGROUND: Shoulder arthroplasty is an effective procedure for managing patients with shoulder pain secondary to end-stage arthritis. Insurance status has been shown to be a predictor of patient morbidity and mortality. The current study evaluated the effect of patient insurance status on perioperative outcomes after shoulder replacement surgery. METHODS: Data between 2004 and 2011 were obtained from the Nationwide Inpatient Sample. Analysis included patients undergoing shoulder arthroplasty (partial, total, and reverse) procedures determined by International Classification of Disease, 9th Revision procedure codes...
February 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162887/intravenous-tranexamic-acid-reduces-total-blood-loss-in-reverse-total-shoulder-arthroplasty-a-prospective-double-blinded-randomized-controlled-trial
#14
Alexander D Vara, Denise M Koueiter, Daphne E Pinkas, Ashok Gowda, Brett P Wiater, J Michael Wiater
BACKGROUND: Patients undergoing reverse total shoulder arthroplasty (RTSA) are at risk of significant perioperative blood loss. To date, few studies have examined the effectiveness of tranexamic acid (TXA) to reduce blood loss in the setting of RTSA. METHODS: In a prospective, double-blinded, single-surgeon trial, we analyzed 102 patients undergoing primary RTSA who were randomized to receive intravenous TXA (n = 53) or placebo (n = 49). Calculated total blood loss, drain output, and hemoglobin (Hb) drop were measured...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162886/dislocation-following-reverse-total-shoulder-arthroplasty
#15
Eitan M Kohan, Peter N Chalmers, Dane Salazar, Jay D Keener, Ken Yamaguchi, Aaron M Chamberlain
BACKGROUND: The etiology of instability following reverse total shoulder arthroplasty (RTSA) remains incompletely understood. The purpose of this study was to describe the shared characteristics, etiologies, and outcomes of early and late dislocations requiring operative revision. METHODS: We identified all patients at our institution who underwent operative revision of an RTSA for instability. Baseline demographic, clinical, and radiographic data were collected...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162884/the-influence-of-three-dimensional-planning-on-decision-making-in-total-shoulder-arthroplasty
#16
Birgit S Werner, Robert Hudek, Klaus J Burkhart, Frank Gohlke
BACKGROUND: Long-term results and complication rates in shoulder arthroplasty are related to implant positioning. Current literature reports increased precision in glenoid component positioning using 3-dimensional (3D) computed tomography (CT) planning tools. This study evaluated the accuracy of glenoid version and inclination measurements using 2D CT scans compared with a validated 3D software program and its influence on decision making on implant selection. METHODS: Preoperative CT scans were obtained from 50 patients undergoing total shoulder arthroplasty...
February 2, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28153684/analysis-of-complication-rates-following-perioperative-transfusion-in-shoulder-arthroplasty
#17
A Jordan Grier, Abiram Bala, Colin T Penrose, Thorsten M Seyler, Michael P Bolognesi, Grant E Garrigues
BACKGROUND: Postoperative anemia requiring a blood transfusion is not uncommon following anatomic total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). However, the potential complications in patients undergoing transfusion after shoulder arthroplasty remain unclear. The goal of this study was to examine the postoperative outcomes of patients receiving blood transfusions following TSA and RTSA. METHODS: Using the Medicare Standard Analytic Files database, we identified all patients undergoing TSA or RTSA between 2005 and 2010...
January 30, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28148463/complications-in-total-shoulder-and-reverse-total-shoulder-arthroplasty-by-body-mass-index
#18
Oke Anakwenze, Alex Fokin, Mary Chocas, Mark T Dillon, Ronald A Navarro, Edward H Yian, Anshuman Singh
INTRODUCTION: The purpose of this study was to identify the effects of body mass index (BMI) on long-term outcomes (revision rate, 1-year mortality rate, 3-year surgical site infection rate, and 90-day inpatient all-cause readmission rate) after total shoulder arthroplasty (TSA) and reverse TSA (RTSA). METHODS: A large shoulder arthroplasty registry was used to review outcomes after TSA and RTSA. The registry monitors patient's revision, mortality, infection, and readmission rates...
January 30, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28145949/histological-evidence-of-muscle-degeneration-in-advanced-human-rotator-cuff-disease
#19
Michael C Gibbons, Anshu Singh, Oke Anakwenze, Timothy Cheng, Maxwill Pomerantz, Simon Schenk, Adam J Engler, Samuel R Ward
BACKGROUND: Cellular remodeling in rotator cuff muscles following a massive rotator cuff tear is poorly understood. The aim of the current study was to provide histological evidence to elucidate the mode of muscle loss in advanced human rotator cuff disease and to assess tissue-level changes in relation to findings on noninvasive imaging. METHODS: Rotator cuff muscle biopsy samples were taken from the scapular fossae from 23 consecutive patients undergoing reverse total shoulder arthroplasty in order to evaluate muscle composition in severe rotator cuff disease...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28139387/the-influence-of-patient-and-surgeon-specific-factors-on-operative-duration-and-early-postoperative-outcomes-in-shoulder-arthroplasty
#20
Jonathan C Clark, Peter Simon, Rachel E Clark, Kaitlyn N Christmas, Jesse W Allert, Jonathan J Streit, Mark A Mighell, Alfred Hess, Jeffrey Stone, Mark A Frankle
BACKGROUND: Increased operative duration has been shown to have demonstrable effects on the outcomes and complications in multiple areas of orthopedic surgery. We sought to determine if patient- and surgeon-specific factors correlated to operative duration in shoulder arthroplasty. Our hypothesis was that increased surgeon and trainee volume would decrease operative times and that more complex pathology would increase operative duration. METHODS: A retrospective review of primary and revision total and reverse shoulder arthroplasties performed at a single institution from 2012 through 2015 was performed evaluating the correlation between specific patient and surgeon factors and operative duration...
January 27, 2017: Journal of Shoulder and Elbow Surgery
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