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Elbow arthroplasty

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https://www.readbyqxmd.com/read/28221245/an-articulating-antibiotic-cement-spacer-for-first-stage-reconstruction-for-infected-total-elbow-arthroplasty
#1
Kanishka E Williams, Simon MacLean, Jesse Jupiter, Gregory I Bain
Management of an infected total elbow replacement is a significant clinical challenge. Although preservation of the prosthesis is ideal, a 2-stage revision is often necessary. Unlike lower limb arthroplasty, antibiotic spacers are not commercially available. Monoblock cement spacers do not allow elbow movements and are therefore associated with severe stiffness and scarring, leading to poor clinical outcomes. In our paper we present a simple and novel technique for constructing an articulating antibiotic-impregnated spacer for use as an implant for a 1-stage revision of an infected elbow arthroplasty...
February 17, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28216759/pseudotumor-due-to-metallosis-after-total-elbow-arthroplasty
#2
Roberto Rotini, Graziano Bettelli, Michele Cavaciocchi, Lucia Savarino
The incidence of primary total elbow arthroplasty (TEA) in young patients is increasing. The indications for revision surgery are also rising. Here, we report a rare case of pseudotumor detected in a patient 16 years after TEA. Intraoperative findings revealed a necrotic mass characterized by a conspicuous metallosis in the soft tissues around the prosthesis, which caused ulnar nerve dislocation. Due to this anatomical change, a lesion of the nerve was accidentally produced during revision surgery. The case report emphasizes that the indications for elbow replacement, as well as the patient education about the permanent physical limitations, should be carefully considered...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28209327/outcomes-of-total-shoulder-arthroplasty-in-patients-younger-than-65-years-a-systematic-review
#3
REVIEW
Troy A Roberson, Jared C Bentley, James T Griscom, Michael J Kissenberth, Stefan J Tolan, Richard J Hawkins, John M Tokish
BACKGROUND: Despite concerns about the longevity of total shoulder arthroplasty (TSA) in young patients, it remains an attractive option because of the absence of superior options. METHODS: A systematic review was performed using searches of PubMed, Embase, and Cochrane databases. English-language studies were identified with search terms "total shoulder arthroplasty" (title/abstract) or "shoulder replacement" (title/abstract) and "young" (title/abstract) or "under 65 years of age" (title/abstract)...
February 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28190668/resilience-correlates-with-outcomes-after-total-shoulder-arthroplasty
#4
John M Tokish, Michael J Kissenberth, Stefan J Tolan, Tariq I Salim, Josh Tadlock, Thomas Kellam, Catherine D Long, Ashley Crawford, Keith T Lonergan, Richard J Hawkins, Ellen Shanley
BACKGROUND: Resilience, characterized by an ability to bounce back or recover from stress, is increasingly recognized as a psychometric property affecting many outcomes' domains including quality of life, suicide risk in active-duty military personnel, and recovery in cancer patients. This study examines the correlation between resilience, as measured by the Brief Resilience Scale (BRS), and traditional outcome scores including the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Penn scores in patients undergoing total shoulder arthroplasty (TSA)...
February 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28166703/a-muscle-sparing-posterior-approach-to-the-elbow-joint-for-total-elbow-arthroplasty
#5
Ravi Sreenivasan, Pritish Singh, Simon Thomas, Anuj Jain, Harjoban Singh, Shekhar Agarwal
We describe a muscle sparing approach in which the triceps is elevated without injuring the muscle or disturbing its insertion. The entire extensor mechanism is preserved in continuity, thus preventing any extensor weakness. This can be used preferentially in cases of non-union intraarticular distal humerus fractures planned for Total Elbow Arthroplasty.
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28164052/treatment-of-stiff-elbow-in-young-patients-with-interpositional-arthroplasty-for-mobility-case-series
#6
R Sivakumar, V SomaSheker, Prahalad Kumar Shingi, T Vinoth, M Chidambaram
INTRODUCTION: The elbow is a complex joint involving many articulations and complex biomechanics come into play. Elbow motion is crucial to upper limb movement that loss of 50% of elbow function equals to loss of 80% of upper extremity global function. Restoring movement and stability is challenging to the surgeon while treating a stiff elbow. Unlike other arthroplasties of hip and knee, total elbow arthroplasty (TEA) may not be a primary treatment. Interpositional arthroplasty (IPA) can be considered a viable option in posttraumatic arthritis of elbow in young patients...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28162882/reverse-shoulder-arthroplasty-for-four-part-proximal-humerus-fracture-in-elderly-patients-can-a-healed-tuberosity-improve-the-functional-outcomes
#7
Yong-Min Chun, Doo-Sup Kim, Doo-Hyung Lee, Sang-Jin Shin
BACKGROUND: The purpose of this study was to investigate whether healed tuberosities yield better rotational range of motion (ROM) and functional outcomes compared with unhealed tuberosities after reverse shoulder arthroplasty in elderly patients with comminuted proximal humerus fractures. METHODS: This study included 38 patients who underwent reverse arthroplasty because of 4-part proximal humerus fractures; 14 patients had healed tuberosities (group A) and 24 patients had unhealed tuberosities (group B)...
February 2, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162881/midterm-results-of-osteochondral-allograft-transplantation-to-the-humeral-head
#8
Andrew J Riff, Adam B Yanke, Jason J Shin, Anthony A Romeo, Brian J Cole
BACKGROUND: This study evaluated clinical outcomes of osteochondral allograft (OCA) transplantation for humeral head osteochondral defects. We hypothesized that patients with isolated humeral head disease would achieve favorable results and that patients with bipolar disease would experience inferior outcomes. METHODS: We identified patients who underwent humeral head OCA transplantation. Subjective questionnaire data were obtained preoperatively and at a minimum of 2 years postoperatively...
February 2, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28159475/risk-factors-for-reoperation-after-total-elbow-arthroplasty
#9
Donato Perretta, Wouter F van Leeuwen, George Dyer, David Ring, Neal Chen
BACKGROUND: Total elbow arthroplasty (TEA) is a treatment option for arthritic conditions of the elbow and for complex distal humerus fractures in the elderly. Complications are common, however, and rates of survivorship vary. The goal of this study was to describe the factors associated with reoperation and revision after TEA. METHODS: We retrospectively reviewed primary TEAs performed at 2 tertiary academic medical centers. We identified 102 primary TEAs in 82 patients by 9 surgeons...
January 31, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28159474/proximal-ingrowth-coating-decreases-risk-of-loosening-following-uncemented-shoulder-arthroplasty-using-mini-stem-humeral-components-and-lesser-tuberosity-osteotomy
#10
Michael P Morwood, Peter S Johnston, Grant E Garrigues
BACKGROUND: Mini-stem humeral component (MSHC) use during total shoulder arthroplasty (TSA) provides bone preservation and ease of revision. MSHCs rely solely on proximal metaphyseal fixation; some early reports have demonstrated an unacceptably high rate of early loosening. To our knowledge, no study analyzing the effect of proximal porous coating on MSHCs has been performed. METHODS: We performed a retrospective review of consecutive patients who underwent anatomic TSA using coated or uncoated MSHCs with minimum 2-year follow-up...
January 31, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28155837/aseptic-destruction-of-the-elbow-joint-after-radial-head-replacement-case-study
#11
Marcin Błoński, Andrzej Boszczyk, Stanisław Pomianowski, Mariusz Urban
Radial head replacement should be a routine treatment in cases of non-reconstructable radial head fractures. With the growing number of radial head arthroplasties, we are going to see more complications related to this procedure. We describe a case of aseptic destruction of the elbow joint, probably related to the release of polyethylene particles from the prosthetic head. Removal of the implant and extensive synovectomy was performed, leading to an excellent clinical outcome with reduction of pain and increase in the range of motion...
November 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28155828/elbow-arthroplasty-in-patients-with-bleeding-disorders-preliminary-report-of-a-single-centre-experience
#12
Andrzej Leń, Jerzy Mirosław Jaworski, Joanna Zdziarska, Bartłomiej Skotnicki, Bogusław Frańczuk
Spontaneous or traumatic hemorrhages into joints that occur in the course of congenital bleeding disorders due to deficiencies of plasma clotting factors lead to early and extensive damage to joints. Arthropathy in those patients most commonly affects the knee, elbow and ankle. Replacement surgery of the damaged joint is the only effective way to treat such advanced changes. Although arthritis of the elbow is quite common, surgery is rarely undertaken; hence relevant reports in the literature are limited to individual or small groups of cases...
March 23, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28141953/interposition-dermal-matrix-xenografts
#13
Julie A Neumann, Miltiadis H Zgonis, Kathleen D Rickert, Kendall E Bradley, Thomas J Kremen, Blake R Boggess, Alison P Toth
BACKGROUND: Management of massive rotator cuff tears in shoulders without glenohumeral arthritis remains problematic for surgeons. Repairs of massive rotator cuff tears have failure rates of 20% to 94% at 1 to 2 years postoperatively as demonstrated with arthrography, ultrasound, and magnetic resonance imaging. Additionally, inconsistent outcomes have been reported with debridement alone of massive rotator cuff tears, and limitations have been seen with other current methods of operative intervention, including arthroplasty and tendon transfers...
January 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28139385/nonoperative-management-versus-reverse-shoulder-arthroplasty-for-treatment-of-3-and-4-part-proximal-humeral-fractures-in-older-adults
#14
Troy A Roberson, Charles M Granade, Quinn Hunt, James T Griscom, Kyle J Adams, Amit M Momaya, Adam Kwapisz, Michael J Kissenberth, Stefan J Tolan, Richard J Hawkins, John M Tokish
BACKGROUND: The treatment of 3- and 4-part proximal humeral fractures in the older adult is controversial. No study has directly compared reverse shoulder arthroplasty (RSA) with nonoperative treatment for these fractures. The purpose of this study was to compare clinical and patient-reported outcomes between RSA and nonoperative treatment groups. METHODS: A retrospective review was performed on all 3- and 4-part proximal humeral fractures treated with either RSA or nonoperative treatment with minimum 1-year follow-up...
January 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28112785/effect-of-humeral-component-version-on-outcomes-in-reverse-shoulder-arthroplasty
#15
Alexander W Aleem, Brian T Feeley, Luke S Austin, C Benjamin Ma, Ryan J Krupp, Matthew L Ramsey, Charles L Getz
Although reverse shoulder arthroplasty provides excellent clinical results in appropriately selected patients, loss of external and internal rotation may occur. Component selection, design, and placement affect postoperative results. Recent studies considered the effect of humeral component version on functional results. The current study investigated whether humeral stem retroversion affects the outcomes of reverse shoulder arthroplasty with a retrospective review of a multisurgeon, industry-sponsored, prospectively gathered database of a single reverse shoulder arthroplasty implant...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28111179/impact-of-scapular-notching-on-clinical-outcomes-after-reverse-total-shoulder-arthroplasty-an-analysis-of-476-shoulders
#16
Brent Mollon, Siddharth A Mahure, Christopher P Roche, Joseph D Zuckerman
BACKGROUND: Scapular notching is a complication unique to reverse total shoulder arthroplasty (rTSA), although its clinical implications are unclear and remains controversial. METHODS: We retrospectively reviewed rTSA patients of a single implant design in 476 shoulders with a minimum 2-year clinical and radiographic follow-up. Clinical measures included active range of motion and American Shoulder and Elbow Surgeons scores, in addition to one or more of the Constant score, Shoulder Pain and Disability Index, Simple Shoulder Test (SST), and University of California, Los Angeles Shoulder Rating Scale...
January 19, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28109195/fungal-periprosthetic-joint-infection-following-total-elbow-arthroplasty-a-case-report-and-review-of-the-literature
#17
Cory A Kwong, Shannon K T Puloski, Kevin A Hildebrand
BACKGROUND: With improving surgical techniques for total elbow arthroplasty clinical outcomes have improved and its utilization continues to increase. Despite these advances, complication rates remain as high as 24%. Of these complications periprosthetic joint infection is one of the most common and morbid. The rheumatoid elbow remains a leading indication for total elbow arthroplasty. Patients with this condition frequently require immunosuppressive therapy, which places them at higher risk of both typical and atypical infections...
January 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28094191/functional-results-of-bilateral-reverse-total-shoulder-arthroplasty
#18
Chris R Mellano, Noam Kupfer, Robert Thorsness, Peter N Chalmers, Terrence F Feldheim, Patrick O'Donnell, Brian J Cole, Nikhil N Verma, Anthony A Romeo, Gregory P Nicholson
BACKGROUND: The purpose of this study was to analyze a population of patients with bilateral reverse total shoulder arthroplasty (RTSA) to evaluate their ability to perform activities of daily living and personal hygiene tasks. METHODS: At a minimum 2-year follow-up, we retrospectively reviewed 50 patients (100 shoulders) with a mean age of 72 years who underwent staged bilateral RTSA. The average follow-up period was 61 months (range, 24-121 months), with a minimum 2-year follow-up after the second surgical procedure...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089827/plication-of-the-posterior-capsule-for-intraoperative-posterior-instability-during-anatomic-total-shoulder-arthroplasty
#19
Eduard Alentorn-Geli, Andrew T Assenmacher, John W Sperling, Robert H Cofield, Joaquín Sánchez-Sotelo
BACKGROUND: Restoration of soft tissue balance for intraoperative posterior instability during anatomic total shoulder arthroplasty (TSA) is particularly difficult. The effectiveness of posterior capsular plication (PCP) in restoring soft tissue balance is largely unknown. The purpose of this study was to report the outcomes, complications, and reoperations of primary TSA in which a PCP was performed to correct excessive intraoperative posterior subluxation. METHODS: Thirty-eight shoulders (37 patients) underwent PCP for intraoperative posterior instability during anatomic TSA...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089825/clinical-and-radiographic-outcome-of-revision-surgery-of-total-elbow-prosthesis-midterm-results-in-19-cases
#20
Jetske Viveen, Ante Prkic, Koen L M Koenraadt, Izaäk F Kodde, Bertram The, Denise Eygendaal
BACKGROUND: The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty. METHODS: All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs...
January 13, 2017: Journal of Shoulder and Elbow Surgery
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