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Reverse rotator cuff surgery

Andreas Panagopoulos, Irini Tatani, Seferlis Yannis, Bavelou Aikaterini, Antonis Kouzelis, Minos Tyllianakis, Panayotis Dimakopoulos
Background: The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. Objectives: The present study reports the midterm clinical and radiological results of a large series of consecutive patients with 4-part VI fractures treated with a minimal invasive technique of internal fixation. Methods: Over a ten-year period (2004-2014), we treated 56 patients with a true 4-part valgus impacted fracture of the proximal part of the humerus...
2018: Open Orthopaedics Journal
Daniel J Hackett, Jason E Hsu, Frederick A Matsen
BACKGROUND: Primary shoulder hemiarthroplasty is used to address a range of glenohumeral disorders, including fracture, arthritis, avascular necrosis, and capsulorrhaphy arthropathy; some patients with hemiarthroplasties undergo revision surgery for persistent pain or residual shoulder dysfunction. The literature does not clarify the features of the hemiarthroplasties having repeat surgery in a way that can guide surgeons' efforts to minimize the need for revision. To help address this gap, we analyzed the characteristics of patients from our region for whom we performed surgical revision of a prior humeral hemiarthroplasty QUESTIONS/PURPOSES: (1) What are the common characteristics of shoulder hemiarthroplasties having a revision? (2) What are the common characteristics of the subset of revised shoulder hemiarthroplasties that were performed for fracture? (3) What are characteristics of the subset of all revised hemiarthroplasties that were associated with glenoid bone erosion? METHODS: Data for 983 patients for whom we performed a surgical revision of any type of shoulder arthroplasty between January 1991 and January 2017 were identified in our longitudinally maintained institutional arthroplasty revision database...
February 21, 2018: Clinical Orthopaedics and related Research
Sung-Min Rhee, Nam Yun Chung, Hyeon Jang Jeong, Joo Han Oh
BACKGROUND: Subacromial pain pumps are used for analgesia after arthroscopic rotator cuff surgery. However, there is controversy about myotoxic or tendinotoxic effects of local anesthetics. HYPOTHESIS: Ropivacaine administered via a subacromial pain pump would have no adverse effect on rotator cuff tendon healing, fatty degeneration, strength, or functional outcomes after arthroscopic repair. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 1, 2018: American Journal of Sports Medicine
Eric T Ricchetti, Bong-Jae Jun, Richard A Cain, Ari Youderian, Eric J Rodriguez, David Kusin, Naveen Subhas, Thomas E Patterson, Joseph P Iannotti
BACKGROUND: Detection of postoperative component position and implant shift following total shoulder arthroplasty (TSA) can be challenging using routine imaging. The purpose of this study was to evaluate glenoid component position over time using 3-dimensional computed tomography (CT) analysis with minimum 2-year follow-up. METHODS: Twenty patients underwent primary TSA with sequential CT scanning of the shoulder: a preoperative study, an immediate postoperative study within 2 weeks of surgery, and a postoperative study performed at minimum 2-year follow-up (CT3)...
February 7, 2018: Journal of Shoulder and Elbow Surgery
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
Pascal Boileau, Mohammed Baba, Walter B McClelland, Charles-Édouard Thélu, Christophe Trojani, Nicolas Bronsard
BACKGROUND: The purpose of this study was to characterize a subgroup of cuff-deficient patients with isolated loss of active external rotation (ILER) but preserved active elevation and to evaluate the outcomes of the L'Episcopo procedure to restore horizontal muscle balance. METHODS: During a 10-year period, 26 patients (14 men, 12 women) were identified with ILER in the setting of massive irreparable posterosuperior cuff tears. A modified L'Episcopo tendon transfer was performed to restore active external rotation and to improve shoulder function...
December 28, 2017: Journal of Shoulder and Elbow Surgery
Christoph Kolling, Mirela Borovac, Laurent Audigé, Andreas M Mueller, Hans-Kaspar Schwyzer
PURPOSE: This patient survey evaluated the return to previous sports activities in Swiss patients up to five years after reverse shoulder arthroplasty (RSA). METHODS: We screened our local shoulder arthroplasty registry for patients registered with a unilateral RSA due to rotator cuff deficiency between May 2010 and May 2015. Revision cases and patients already known as unwilling or unable to complete a German language questionnaire were excluded. Eligible patients received a paper questionnaire asking about their past and current sports activities, return time point and level of activity...
December 22, 2017: International Orthopaedics
G Porcellini, A Combi, G Merolla, B Bordini, S Stea, G Zanoli, P Paladini
BACKGROUND: Implant registries have proved valuable in assessing the outcomes of arthroplasty procedures. Moreover, by identifying lesser quality implants they have indirectly improved the quality of care. The registry of prosthetic shoulder implants was established in 2008. METHODS: It records information on all types of primary and revision arthroplasty procedures involving the glenohumeral joint, including reverse and total arthroplasty, hemiarthroplasty, resurfacing, removal, and any other surgical procedures that are required to manage these patients...
December 4, 2017: Musculoskeletal Surgery
Derek J Cuff, Derek R Pupello, Brandon G Santoni, Rachel E Clark, Mark A Frankle
We previously evaluated 94 patients (96 shoulders) who underwent reverse shoulder arthroplasty using a central compressive screw with 5.0-mm peripheral locking screws for baseplate fixation and a center of rotation lateral to the glenoid as treatment for end-stage rotator cuff deficiency. The purpose of this study was to report updated results at a minimum follow-up of 10 years. Forty patients (42 shoulders) were available for clinical follow-up. In the patients available for study, implant survivorship, with the end point being revision for any reason, was 90...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
Shu-Jui Kuo, Feng-Sheng Wang, Jih-Yang Ko, Chih-Hsin Tang, Ka-Kit Siu, Ya-Hung Hsu, Tsai-Chen Tsai
BACKGROUND: Shoulder stiffness is a disease manifested by pain, limited range of motion, and functional disability. The inflammatory and fibrosis processes play a substantial role in the pathogenesis of shoulder stiffness. The CB1 receptor has been recognized to mediate the processes of pathologic fibrosis. This study investigated the role of the CB1 pathway in pathogenesis of rotator cuff lesions with shoulder stiffness. METHODS: All of the patients undergoing repair surgery for rotator cuff lesions were recruited and subcategorized into subjects with and without shoulder stiffness...
November 3, 2017: Journal of Shoulder and Elbow Surgery
Mihir Sheth, Jia-Wei Kevin Ko, Surena Namdari
In a systematic review, we critically examined and synthesized the results of individual studies on reverse shoulder arthroplasty (RSA) with latissimus dorsi tendon transfer. Two electronic databases were searched. For each included study, 2 reviewers evaluated the quality of its methods and retrieved data. In cases in which outcomes data were similar between studies, data were pooled using frequency-weighted (FW) mean values to generate summary outcomes. Seven studies met the inclusion and exclusion criteria, and 133 patient cases were reviewed...
September 2017: American Journal of Orthopedics
F Gohlke, B Werner
TECHNIQUE: The treatment of bone defects in primary shoulder arthroplasty has evolved due to more detailed diagnostic tools, 3D planning and expanded indications for reverse shoulder arthroplasty. Glenoid bone defects combined with chronic posterior subluxation of the humeral head are gradually being treated by glenoid reconstruction and reverse implants even if the rotator cuff is still intact. The treatment of advanced bone loss due to glenoid loosening has been facilitated by bone augmentation using a cementless fixation as proposed by Norris...
December 2017: Der Orthopäde
Edward J W Shields, Denise M Koueiter, Tristan Maerz, Adam Schwark, J Michael Wiater
BACKGROUND: Although recent evidence suggests that any prior shoulder surgery may cause inferior shoulder arthroplasty outcomes, there is no consensus on whether previous rotator cuff repair (RCR) is associated with inferior outcomes after reverse total shoulder arthroplasty (RTSA). PURPOSE: To retrospectively compare outcomes in patients who underwent RTSA with and without previous RCR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients with prior RCR and those without previous shoulder surgery (control) who underwent RTSA for cuff tear arthropathy or irreparable cuff tear were retrospectively identified from a prospective database...
October 2017: Orthopaedic Journal of Sports Medicine
Lukas Ernstbrunner, Aline Suter, Sabrina Catanzaro, Stefan Rahm, Christian Gerber
BACKGROUND: There has been serious concern regarding the longevity and durability of outcomes of reverse total shoulder arthroplasty (RTSA) in younger patients. It was the purpose of this study to analyze long-term outcomes and complications of RTSA for irreparable rotator cuff tears in patients younger than 60 years. METHODS: Twenty patients (23 shoulders) with a mean age of 57 years (range, 47 to 59 years) were evaluated at a mean of 11.7 years (range, 8 to 19 years) after RTSA...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
Bassem T Elhassan, Eric R Wagner, Jean-David Werthel, Malo Lehanneur, Julia Lee
BACKGROUND: Management of shoulder arthritis associated with deltoid paralysis can be very challenging. The purpose of this study was to report the outcome of reverse shoulder arthroplasty with pedicled pectoralis transfer to reconstruct the anterior deltoid in patients with symptomatic shoulder arthritis and a paralyzed deltoid. METHODS: This study included 31 patients with an average age of 51 years (range, 27-73 years). All patients had chronic deltoid paralysis with significant loss of function due to progressive arthritis associated with rotator cuff deficiency...
January 2018: Journal of Shoulder and Elbow Surgery
Mohamed Al Ateeq Al Dosari, Shamsi Hameed, Khalid Mukhtar, Aissam Elmhiregh
INTRODUCTION: The usual indication for reverse shoulder arthroplasty is glenohumeral arthritis with inadequate rotator cuff and intact deltoid muscle. We report here a case of reverse shoulder arthroplasty using a lattisimus dorsi flap in a patient with deltoid-deficient shoulder following a gunshot injury. PRESENTATION OF THE CASE: The patient was an otherwise healthy 51-year-old male with a history of gunshot injury of the left shoulder 2006. Upon presentation in 2011, the patient had a loss of most of his shoulder bony and muscular structures...
2017: International Journal of Surgery Case Reports
Chul-Hyun Cho, Du-Han Kim, Kwang-Soon Song
BACKGROUND: There are limited data available regarding the results of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA). We performed a systematic review of the literature to investigate the radiological and clinical outcomes after RSA in patients with RA. METHODS: A literature search for publications between 1987 and 2014 was conducted by 2 independent reviewers using PubMed, Scopus, Embase, and Cochrane Central Register of Controlled Trials...
September 2017: Clinics in Orthopedic Surgery
Matthias Alexander König, Volker Alexander Braunstein
INTRODUCTION: Massive tears in the rotator cuff are debilitating pathologies normally associated with loss of function and pain. Tendon reconstruction is seen as the standard treatment in order to preserve shoulder function and to inhibit cuff associated osteoarthritis. However, the effect on longer-term shoulder function and patient satisfaction is unknown. MATERIAL AND METHODS: 165 consecutive patients with massive tears were included. 57 debridement (mean age 61...
2017: Open Orthopaedics Journal
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...
January 2018: Journal of Shoulder and Elbow Surgery
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...
January 2018: Journal of Shoulder and Elbow Surgery
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