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Shoulder arthroplasty

Benjamin Zmistowski, Eric M Padegimas, Michael Howley, Joseph Abboud, Gerald Williams, Surena Namdari
INTRODUCTION: As policies are implemented to encourage high-quality care, it is important to identify any persistent limitations to the uniform delivery of anatomic and reverse total shoulder arthroplasty (TSA). The study's goal was to assess current TSA use and identify predictors of geographic variability. METHODS: We used data from 2012 through 2014 that was obtained from public Medicare databases to identify the case volume, locations, and names of surgeons performing >10 TSAs annually...
January 18, 2018: Journal of the American Academy of Orthopaedic Surgeons
Jacob M Reeves, George S Athwal, James A Johnson
BACKGROUND: Shoulder arthroplasty humeral components have undergone several generational changes, with systems now offering shorter stems and stemless options. The stemless humeral implants obtain fixation in the trabecular bone of the proximal humerus through elaborate fixation features. To optimize implant design, the regional variations in bone density within the proximal humerus should be determined. As such, the purpose of this computed tomography-based study was to map the regional variations in bone density of the proximal humerus...
January 11, 2018: Journal of Shoulder and Elbow Surgery
Madeleine L Van de Kleut, Xunhua Yuan, George S Athwal, Matthew G Teeter
A phantom study was conducted to determine bias in motion and bias at zero motion of radiostereometric analysis (RSA) for evaluating implant relative displacement in reverse total shoulder arthroplasty (RTSA). A Sawbones shoulder phantom was fitted with a RTSA implant set and 13 tantalum markers. The model was fixed to a manual micrometer, providing controlled movements though fifteen known increments in translation and twelve increments in rotation (0.02-5.00 mm and 0.1-6.0°), along each translation and rotation axis...
December 26, 2017: Journal of Biomechanics
Antonio Pellegrini, Claudio Legnani, Vittorio Macchi, Enzo Meani
INTRODUCTION: Management of periprosthetic shoulder infections (PSIs) still remains challenging. We conducted a retrospective case study to assess the outcomes of definitive articulating antibiotic spacer implantation in a cohort of elderly, low-demanding patients. We hypothesized that in patients with low functional demands seeking pain relief with chronic PSIs, treatment with a definitive articulating antibiotic spacer would lead to satisfying results concerning eradication of the infection, improvement of pain, and improving shoulder function...
January 15, 2018: Archives of Orthopaedic and Trauma Surgery
Jay D Keener, Brendan M Patterson, Nathan Orvets, Alexander W Aleem, Aaron M Chamberlain
BACKGROUND: Our study purpose was to determine the optimal glenoid and humeral reverse shoulder arthroplasty (RSA) component design and position in osteoarthritic shoulders with severe glenoid retroversion deformities. METHODS: Computed tomography scans from 10 subjects were analyzed with advanced software including RSA range of motion (ROM) analysis. Variables included glenoid component retroversion of 0°, 5°, 10°, 15°, and 20° and baseplate lateralization of 0, 5, and 10 mm...
February 2018: Journal of Shoulder and Elbow Surgery
M D Herrick, H Liu, M Davis, J-E Bell, B D Sites
BACKGROUND: Regional anesthesia can be used as part of the anesthetic to optimize anesthesia and analgesia during shoulder arthroplasty, but little is known about the overall effect that regional anesthesia has on perioperative outcomes and resource utilization. We hypothesized that regional anesthesia may decrease complication rates and resource utilization in shoulder arthroplasty patients. METHODS: We examined administrative data from 588 US hospitals from 2010 to 2015...
January 7, 2018: Acta Anaesthesiologica Scandinavica
Michael D Kurdziel, Michael D Newton, Samantha Hartner, Kevin C Baker, J Michael Wiater
Polyethylene wear is a known complication in total joint arthroplasty, however, in vivo wear rates in reverse total shoulder arthroplasty (RTSA) remain largely unknown. This study aimed to quantify volumetric and surface deviation changes in retrieved RTSA humeral liners using a novel micro-computed tomography (µCT)-based technique. After IRB-approval, 32 humeral liners (single manufacturer and model) with term-of-service greater than 90 days were analyzed. Clinical demographics and surgical data were collected via chart review...
January 4, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Jason E Hsu, Daniel J Hackett, Kiet V Vo, Frederick A Matsen
BACKGROUND: Glenoid component failure is a prevalent mechanical complication of anatomic total shoulder arthroplasty. The objective of this study was to identify surgeon-controlled factors that may be addressed to reduce the rate of glenoid component failure that is sufficiently symptomatic to merit surgical revision. METHODS: We reviewed the clinical and radiographic features of 215 total shoulder arthroplasties that we revised for symptomatic glenoid component failure...
January 5, 2018: Journal of Shoulder and Elbow Surgery
David M Levy, Joshua A Metzl, G Christian Vorys, William N Levine, Christopher S Ahmad, Louis U Bigliani
In total shoulder arthroplasty (TSA), glenoid prostheses have conforming or nonconforming designs. A hybrid glenoid was designed with dual radii of curvature: a central conforming region surrounded by an outer nonconforming region. We retrospectively reviewed the cases of 169 patients who underwent 196 hybrid glenoid prosthesis TSAs for primary glenohumeral arthritis. Clinical data, retrieved for 178 shoulders at a mean follow-up of 4.8 years, included physical examination, 36-Item Short Form Health Survey (SF-36), American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), subjective Neer criteria, and postoperative complication data...
November 2017: American Journal of Orthopedics
Muriel J Solberg, Arnold B Alqueza, Tyler J Hunt, Laurence D Higgins
Shared decision-making provides patients a measure of autonomy in making choices for their health and their future. Patient-reported outcome measures (PROMs) use clinically sensitive and specific metrics to evaluate a patient's self-reported pain, functional ability, and mental state. We conducted a study to create an evidence-based clinical decision-making tool. We used PROMs to create a predictive model of a patient's outcome to help set patient expectations and facilitate a collaborative decision-making environment for patient and physician...
November 2017: American Journal of Orthopedics
Alan M Hirahara, Wyatt J Andersen, Alberto J Panero
Superior capsular reconstruction (SCR) is performed to reduce the pain and disability caused by irreparable supraspinatus rotator cuff tears (RCTs). In this article, we discuss 9 cases of irreparable rotator cuff tears managed with arthroscopic SCR with dermal allograft. At minimum 2-year follow-up (mean, 32.38 months), the patients were prospectively evaluated on the American Shoulder and Elbow Surgeons (ASES) shoulder index, a visual analog scale (VAS) for pain, acromial-humeral distance, and ultrasonography...
November 2017: American Journal of Orthopedics
Francesco Ascione, Peter Domos, Vincenzo Guarrella, Mikaël Chelli, Pascal Boileau, Gilles Walch
BACKGROUND: Recent experiences with Grammont reverse shoulder arthroplasty (RSA) have revealed some problems related to the biomechanical changes of the shoulder and humeral stem complications. We analyzed humeral complications in a long-term follow-up of a large series of RSAs, searching for correlations between these and the initial etiology, the follow-up duration, and the clinical outcomes. MATERIALS AND METHODS: Preoperative and postoperative clinical and radiologic assessments of 1035 RSAs with a minimum 5-year follow-up (implanted in 7 specialized shoulder centers between 1993 and 2010) were retrospectively collected...
January 4, 2018: Journal of Shoulder and Elbow Surgery
Michael P Leathers, Marc N Ialenti, Brian T Feeley, Alan L Zhang, C Benjamin Ma
BACKGROUND: As surgeons have become more adept and midterm to long-term results have demonstrated improved patient outcomes, the indications for reverse total shoulder arthroplasty (RTSA) have expanded. This study compares the clinical outcomes and complication rates between patients 65 years and younger and patients 70 years and older undergoing RTSA. METHODS: A retrospective analysis of a prospectively collected cohort with minimum 2-year follow-up was performed at a single institution...
January 5, 2018: Journal of Shoulder and Elbow Surgery
Ashish Gupta, Christoph Thussbas, Michael Koch, Ludwig Seebauer
BACKGROUND: Management of significant glenoid bone loss in patients undergoing a reverse shoulder arthroplasty (RSA) poses a significant treatment challenge. The long-term outcome of single-stage RSA with glenoid bone grafting is unknown. This study assesses the indications, technique, and outcome of RSA with glenoid bone grafting. MATERIALS AND METHODS: Between 2001 and 2010, there were 1074 RSAs performed at our institution; 94 patients had significant glenoid bone loss...
January 3, 2018: Journal of Shoulder and Elbow Surgery
Thuy Trang Pham, Stéphanie Delclaux, Sandrine Huguet, Matthieu Wargny, Nicolas Bonnevialle, Pierre Mansat
BACKGROUND: Total elbow arthroplasty is a therapeutic option for severe rheumatoid arthritis. We hypothesized that the semiconstrained characteristics of the Coonrad-Morrey prosthesis do not compromise the survival rate of the implant in a rheumatoid elbow. METHODS: Between 1997 and 2012, there were 54 Coonrad-Morrey total elbow prostheses performed for rheumatoid arthritis in 46 patients. Minimum follow-up was 2 years. There were 35 women and 11 men with a mean age of 60 years (29-83 years)...
January 4, 2018: Journal of Shoulder and Elbow Surgery
N Hawi, S Razaeian, C Krettek, R Meller, E Liodakis
The torsion of the humerus describes the physiological rotation of the humerus around its longitudinal axis. Various clinical and radiological methods for measurement have been described. The computed tomography method is currently the gold standard. The angle between the humeral head axis and the transepicondylar axis is measured. This angle is called retroversion. Values of retroversion vary between 10° and 40°. For the treatment of many humeral pathologies, a precise reconstruction of the anatomical retroversion is required...
January 5, 2018: Der Unfallchirurg
Dell C McLaughlin, Jonathan W Cheah, Pedram Aleshi, Alan L Zhang, C Benjamin Ma, Brian T Feeley
BACKGROUND: Studies on perioperative pain control in shoulder arthroplasty focus on regional anesthesia, with little research on other approaches. Perioperative multimodal analgesia regimens decrease opioid intake and opioid-related side effects in lower-extremity arthroplasty. In this study we compare pain scores, opioid consumption, length of stay, and readmission rates in postoperative shoulder arthroplasty patients treated with a standard or multimodal analgesia regimen. METHODS: A prospective cohort analysis was performed at a single institution...
January 3, 2018: Journal of Shoulder and Elbow Surgery
Christian Gerber, Sandro Canonica, Sabrina Catanzaro, Lukas Ernstbrunner
HYPOTHESIS: This study investigated the hypothesis that functional outcome remains significantly improved over the preoperative state beyond 15 years of reverse total shoulder arthroplasty (RTSA) for irreparable rotator cuff dysfunction. METHODS: Operations were performed on 22 shoulders at a mean age of 68 (range, 54-77) years. The patients could personally be reviewed clinically and radiographically in intervals of 2 to 5 years and with a final follow-up examination at no less than 15 years (mean, 16...
January 3, 2018: Journal of Shoulder and Elbow Surgery
Pascal Boileau, Damien Cheval, Marc-Olivier Gauci, Nicolas Holzer, Jean Chaoui, Gilles Walch
BACKGROUND: Preoperative computed tomography (CT) measurements of glenoid version and inclination are recommended for planning glenoid implantation in shoulder arthroplasty. However, current manual or semi-automated 2-dimensional (2D) and 3-dimensional (3D) methods are user-dependent and time-consuming. We assessed whether the use of a 3D automated method is accurate and reliable to measure glenoid version and inclination in osteoarthritic shoulders. METHODS: CT scans of osteoarthritic shoulders of 60 patients scheduled for shoulder arthroplasty were obtained...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
Jacob M Reeves, James A Johnson, George S Athwal
BACKGROUND: Shoulder arthroplasty evolution has resulted in the shortening of traditional stemmed humeral components. Newer stemless implants rely on structures that maintain fixation in the metaphyseal region of the proximal humerus. Whereas the overall morphology of the proximal humerus is well understood, the advent of stemless implants requires that additional geometric measures be assessed. This study's purpose was to introduce new anatomic measures to assist with the design of stemless implants...
December 29, 2017: Journal of Shoulder and Elbow Surgery
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