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Shoulder arthroplasty

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https://www.readbyqxmd.com/read/27909126/medium-term-outcomes-of-the-universal-2-total-wrist-arthroplasty-in-patients-with-rheumatoid-arthritis
#1
R Badge, K Kailash, D R Dickson, S Mahalingam, A Raza, A Birch, D Nuttall, S R Murali, M J Hayton, S Talwalkar, A C Watts, I A Trail
AIMS: The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis. PATIENTS AND METHODS: This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#2
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27904932/-the-reverse-shoulder-arthroplasty-delta-xtend-mid-term-results
#3
S Gruber, C Schoch, M Geyer
BACKGROUND: Reverse shoulder arthroplasty (RSA) has become a frequently used and established treatment for patients with cuff tear arthropathy, increasingly also for patients with fracture sequelae (FS), failed rotator cuff reconstruction and omarthrosis with cuff insufficiency. Since 2007 new generation prostheses, for example Delta Xtend (Depuy, Warsaw, USA), have been used, but few mid-term results have been published. OBJECTIVES: The aim of this study is to report on the outcome after RSA after a mean follow-up of 68 months (range 63-75), to verify the already published, encouraging early results and to learn about the function and pain situation after RSA in the mid-term period...
November 30, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27900710/customized-tantalum-augmented-reverse-shoulder-arthroplasty-for-glenoid-bone-defect-and-excessive-medialization-description-of-the-technique
#4
Nicola Ivaldo, Tony Mangano, Giovanni Caione, Mario Rossoni, Angelo Ligas
BACKGROUND: Glenoid bone defect and excessive medialization could represent challenging issues during reverse shoulder arthroplasty, especially in the setting of revision surgery. Although a solution is offered by the Boileau's BIO-RSA technique in primary cases, only autologous iliac crest bone graft and homologous graft from bone banks are available for revision surgeries, with known disadvantages and risk of graft resorption and implant failure. MATERIALS AND METHODS: We describe in this work a new technique based on a customized porous tantalum device to be used in salvage situations, aimed at lateralization of the glenoid component of a reverse shoulder arthroplasty...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900702/metallosis-in-shoulder-arthroplasty-an-integrative-review-of-literature
#5
REVIEW
Paritosh Gogna, Paolo Paladini, Giovanni Merolla, Carlo Alberto Augusti, De Falco Maddalena, Giuseppe Porcellini
Shoulder arthroplasty has gained popularity as an efficient means of achieving pain relief and improved function in a variety of complex shoulder disorders. Despite promising reports, given the increasing number of shoulder arthroplasty procedures, various causes that may contribute to failure of a well-functioning arthroplasty are being increasingly recognized. One such disastrous condition is metallosis, a subject which has not been much talked off with reference to shoulder arthroplasty. This article besides reviewing the existing literature intends to discuss the possible causes that contribute to metallosis and devise a protocol for its timely diagnosis and management...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900313/semitendinosus-and-gracilis-free-muscle-tendon-graft-for-repair-of-massive-rotator-cuff-tears-surgical-technique
#6
Antonio Gigante, Carlo Bottegoni, Giuseppe Milano, Michele Riccio, Luca Dei Giudici
Massive rotator cuff tears are difficult to treat surgically due to retraction, degeneration and fraying of the ends of torn tendons, severe fatty infiltration and atrophy of the respective muscles. Procedures developed to close the gap between the rotator cuff and the greater tuberosity of the humerus, such as soft tissue release may be inadequate for large tears. Human or porcine dermal allografts still have uncertain benefits, and tendon transfers seem to be associated with poor outcomes, donor site morbidity and altered mechanics...
July 2016: Joints
https://www.readbyqxmd.com/read/27900271/prosthetic-design-of-reverse-shoulder-arthroplasty-contributes-to-scapular-notching-and-instability
#7
Gazi Huri, Filippo Familiari, Nima Salari, Steve A Petersen, Mahmut Nedim Doral, Edward G McFarland
AIM: To evaluate whether implant design, glenoid positioning, and other factors influenced instability and scapular notching in reverse total shoulder arthroplasty. METHODS: We retrospectively reviewed records of patients who had undergone reverse total shoulder arthroplasty by the senior author from July 2004 through October 2011 and who had at least 24 mo of follow-up. The 58 patients who met the criteria had 65 arthroplasties: 18 with a Grammont-type prosthesis (Grammont group) and 47 with a lateral-based prosthesis (lateral-design group)...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27896292/shoulder-arthroplasty-outcomes-in-patients-with-multiple-reported-drug-allergies-does-number-of-drug-allergies-have-an-effect-on-outcome
#8
Brett D Rosenthal, Michael J Knesek, Cynthia A Kahlenberg, Harry Mai, Matthew D Saltzman
BACKGROUND: The presence of multiple allergies has been correlated with worse outcomes for patients undergoing hip and knee arthroplasty, but the effect of allergies has not yet been elucidated with respect to shoulder arthroplasty. PURPOSE/HYPOTHESIS: The purpose of this study is to identify any discrepancies in shoulder arthroplasty outcomes with respect to reported drug allergies. We hypothesized that patients with multiple drug allergies would have inferior outcomes...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27887875/two-stage-revision-for-infected-shoulder-arthroplasty
#9
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/27887873/a-rapid-method-for-detecting-propionibacterium-acnes-in-surgical-biopsy-specimens-from-the-shoulder
#10
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/27887871/radiographic-results-of-augmented-all-polyethylene-glenoids-in-the-presence-of-posterior-glenoid-bone-loss-during-total-shoulder-arthroplasty
#11
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/27881929/rasch-analysis-of-the-western-ontario-osteoarthritis-of-the-shoulder-index-the-danish-version
#12
Sahar Moeini, Jeppe V Rasmussen, Tobias W Klausen, Stig Brorson
PURPOSE: The Western Ontario Osteoarthritis of the Shoulder (WOOS) index is a disease-specific, patient-reported, 19-question survey that measures the quality of life among patients with osteoarthritis (OA). The purpose of this study was to validate the Danish version of WOOS for OA and fractures (FRs) using modern test theory. PATIENTS AND METHODS: The study included 1,987 arthroplasties in 1,943 patients that were reported to the Danish Shoulder Arthroplasty Register between 2006 and 2011...
2016: Patient related Outcome Measures
https://www.readbyqxmd.com/read/27869623/contamination-of-the-surgical-field-with-propionibacterium-acnes-in-primary-shoulder-arthroplasty
#13
Travis M Falconer, Mohammed Baba, Lisa M Kruse, Oscar Dorrestijn, Matthew J Donaldson, Margaret M Smith, Melanie C Figtree, Bernard J Hudson, Benjamin Cass, Allan A Young
BACKGROUND: Propionibacterium acnes is a common pathogen identified in postoperative shoulder infection. It has been shown to be present in culture specimens during primary shoulder arthroplasty; however, recent work has suggested that it is most likely to be a contaminant. Our aim was to identify the potential sources of contamination in shoulder arthroplasty. METHODS: Tissue swabs were obtained for microbiological analysis from consecutive patients undergoing primary shoulder arthroplasty...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27862245/radiolucency-in-stemless-shoulder-arthroplasty-is-associated-with-an-imaging-phenomenons
#14
Robert Hudek, Birgit Werner, Ayman F Abdelkawi, Rainer Schmitt, Frank Gohlke
Stemless humeral implants show comparable midterm clinical results compared to stemmed components. Recently, radiolucencies around the metaphyseal seating of humeral stemless implants were reported on postoperative radiographs. It is controversial whether they are attributable to bone resorption. We hypothesized these radiolucencies result from imaging artifacts. Seven cadaveric specimens (3 male and 4 female) were first radiographed and then scanned with CT. A stemless humeral component of current design was implanted in each specimen...
November 10, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27861604/effectiveness-and-safety-of-interventions-for-treating-adults-with-displaced-proximal-humeral-fracture-a-network-meta-analysis-and-systematic-review
#15
Long Chen, Fei Xing, Zhou Xiang
PURPOSE: Network meta-analysis (NMA) is a comparatively new evidence-based technique in medical disciplines which compares the relative benefits associated with multiple interventions and obtains hierarchies of these interventions for various treatment options. We evaluated the effectiveness and safety of open reduction and internal fixation (ORIF), hemiarthroplasty (HA), reverse shoulder arthroplasty (RSA), intramedullary nailing (IN) and non-operative treatment (NOT) of displaced proximal humeral fractures in adults using Bayesian NMA of data from clinical trials...
2016: PloS One
https://www.readbyqxmd.com/read/27858226/conversions-from-anatomic-shoulder-replacements-to-reverse-total-shoulder-arthroplasty-do-the-indications-for-initial-surgery-influence-the-clinical-outcome-after-revision-surgery
#16
Malte Holschen, Bastian Franetzki, Kai-Axel Witt, Dennis Liem, Jörn Steinbeck
INTRODUCTION: The most frequent indications for anatomic shoulder replacement are glenohumeral osteoarthritis and fractures of the humeral head. If anatomic shoulder prostheses fail, reverse total shoulder arthroplasty is often the only remaining treatment option. This study evaluates the influence of indications for primary shoulder arthroplasty on the clinical outcome after conversion to reverse total shoulder arthroplasty. MATERIALS AND METHODS: From 2010 to 2012, 44 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty...
November 17, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27858087/three-dimensional-analysis-of-the-proximal-humeral-and-glenoid-geometry-using-microscribe-3d-digitizer
#17
Wejdan H Owaydhah, Mohammad A Alobaidy, Abdulrahman S Alraddadi, Roger W Soames
PURPOSE: To understand the geometry of the proximal humerus and glenoid fossa to facilitate the design of components used in shoulder arthroplasty. The aim is to evaluate the geometry of the proximal humerus and glenoid fossa and their relationship using a MicroScribe 3D digitizer. METHODS: Scans and measurements were obtained from 20 pairs of dry proximal humeri and scapulae [10 female and 10 male cadavers: median age 81 years (range 70-94 years)] using a MicroScribe 3D digitizer and Rhinoceros software...
November 17, 2016: Surgical and Radiologic Anatomy: SRA
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
#18
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
#19
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
#20
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
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