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Elbow arthroplasty

Rony-Orijit Dey Hazra, Helmut Lill, Gunnar Jensen, Julia Imrecke, Alexander Ellwein
Around one third of humeral fractures and 2-6% of all fractures occur to the distal part of the humerus. There is a bimodal distribution differentiating between young male patients with high-energy and elderly female patients with low-energy trauma related to osteoporosis. The AO classification and Dubberley subclassification are used in daily routine. Most fractures are diagnosed on radiographs. For further evaluation, three-dimensional computed tomography is recommended, especially for comminuted or complex fractures...
2018: Obere Extremität
Clay G Nelson, Tyler J Brolin, Marcus C Ford, Richard A Smith, Frederick M Azar, Thomas W Throckmorton
BACKGROUND: To determine the effectiveness of hybrid glenoid components in reducing the frequency of glenoid component loosening, we evaluated clinical and radiographic outcomes at a minimum 5-year follow-up in 45 shoulders that underwent total shoulder arthroplasty (TSA) using a system with a central porous titanium post to augment the cemented peripheral pegs. METHODS: Function and pain were evaluated with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment score, visual analog scale, active shoulder range of motion, and strength...
March 8, 2018: Journal of Shoulder and Elbow Surgery
Will B J Rudge, Kelechi Eseonu, Matthew Brown, Simon Warren, Addie Majed, Ian L Bayley, Simon M Lambert, Deborah Higgs, Mark Falworth
BACKGROUND: Deep prosthetic infection is a potentially devastating complication after total elbow arthroplasty, with an incidence of up to 12%. This study examined the demographics, microbiologic profile, and outcomes of infected total elbow arthroplasty treated with 2-stage revision in a tertiary referral unit. METHODS: We identified 19 consecutive patients (mean age, 65 years) undergoing revision arthroplasty for deep prosthetic infection. All patients underwent a first-stage procedure with removal of implants, débridement, and insertion of an antibiotic-loaded cement spacer, followed by at least 6 weeks of intravenous antibiotics...
March 1, 2018: Journal of Shoulder and Elbow Surgery
Nathan D Orvets, Aaron M Chamberlain, Brendan M Patterson, Peter N Chalmers, Michelle Gosselin, Dane Salazar, Alexander W Aleem, Jay D Keener
BACKGROUND: This study describes the short-term functional and radiographic outcomes after total shoulder arthroplasty (TSA) in shoulders with a B2 glenoid deformity addressed with corrective reaming. METHODS: We conducted a retrospective series of consecutive patients who underwent TSA with a Walch B2 glenoid quantified by computed tomography scan. All glenoid deformities were addressed using partially corrective glenoid reaming. Radiographic and functional outcome measures, including scores on the visual analog scale for pain, American Shoulder and Elbow Standardized Shoulder Assessment, and Simple Shoulder Test were collected...
February 28, 2018: Journal of Shoulder and Elbow Surgery
Ki-Tae Na, Seok-Whan Song, Yoon-Min Lee, Jae-Hoon Choi
BACKGROUND: Triceps weakness is a common complication of total elbow arthroplasty (TEA). Many posterior approaches for TEA have been introduced to maintain triceps function. The present study evaluated the clinical outcomes and extensor strengths of primary TEA with modified triceps fascial tongue approach. METHODS: Twenty-one primary TEAs performed in 20 patients by a single surgeon were reviewed with a mean of 64.2 months (range, 24-127 months) of follow-up. Every TEA was performed using the modified triceps fascial tongue approach, with the Coonrad-Morrey prosthesis...
February 26, 2018: Journal of Shoulder and Elbow Surgery
Gregory T Mahony, Brian C Werner, Brenda Chang, Brian M Grawe, Samuel A Taylor, Edward V Craig, Russell F Warren, David M Dines, Lawrence V Gulotta
BACKGROUND: Although anatomic total shoulder arthroplasty (TSA) successfully improves pain and function, not all patients improve clinically. This study was conducted to determine patient-related factors for failure to achieve improvement after primary TSA for osteoarthritis at 2 years postoperatively. METHODS: This prospective study reviewed an institutional shoulder registry for consecutive patients who underwent primary TSA for osteoarthritis from 2007 to 2013 with baseline and 2-year postoperative American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form scores...
February 23, 2018: Journal of Shoulder and Elbow Surgery
Joseph N Liu, Grant H Garcia, Alexandra C Wong, Alec Sinatro, Hao-Hua Wu, David M Dines, Russell F Warren, Lawrence V Gulotta
As the number of anatomic total shoulder arthroplasties performed on younger patients continues to grow, return to work after surgery becomes increasingly important. The purpose of this study was to evaluate the ability of anatomic total shoulder arthroplasty to return patients 55 years or younger to work postoperatively. A retrospective review was performed of consecutive anatomic total shoulder arthroplasty patients. Inclusion criteria were age 55 years or younger at surgery, greater than 2 years of follow-up, and employment within 3 years of surgery...
February 16, 2018: Orthopedics
Jonathan P Evans, Chris D Smith, Nicola F Fine, Ian Porter, Jaheeda Gangannagaripalli, Victoria A Goodwin, Jose M Valderas
BACKGROUND: Clinical rating systems are used as outcome measures in clinical trials and attempt to gauge the patient's view of his or her own health. The choice of clinical rating system should be supported by its performance against established quality standards. METHODS: A search strategy was developed to identify all studies that reported the use of clinical rating systems in the elbow literature. The strategy was run from inception in Medline Embase and CINHAL...
February 12, 2018: Journal of Shoulder and Elbow Surgery
P Jungbluth, S Tanner, J Schneppendahl, J-P Grassmann, M Wild, M Hakimi, J Windolf, R Laun
AIMS: The aim of this retrospective multicentre study was to evaluate mid-term results of the operative treatment of Monteggia-like lesions and to determine the prognostic factors that influence the clinical and radiological outcome. PATIENTS AND METHODS: A total of 46 patients (27 women and 19 men), with a mean age of 57.7 years (18 to 84) who had sustained a Monteggia-like lesion were followed up clinically and radiologically after surgical treatment. The Mayo Modified Wrist Score (MMWS), Mayo Elbow Performance Score (MEPS), Broberg and Morrey Score, and Disabilities of the Arm, Shoulder and Hand (DASH) score were used for evaluation at a mean of 65 months (27 to 111) postoperatively...
February 2018: Bone & Joint Journal
Scott T Watson, Garland K Gudger, Catherine D Long, John M Tokish, Stefan J Tolan
BACKGROUND: As glenoid failure is one of the primary causes of failure of anatomic total shoulder arthroplasty (TSA), Trabecular Metal-backed glenoid components have become popular. This study reports implant survival and clinical outcomes of patients who received a Trabecular Metal-backed glenoid component during primary anatomic TSA. METHODS: Patients who underwent TSA with a Trabecular Metal-backed glenoid component by a single surgeon were identified and reviewed for clinical, radiographic, and patient-reported outcome measures with a minimum of 2 years' follow-up...
March 2018: Journal of Shoulder and Elbow Surgery
Alexander Klug, Yves Gramlich, Johannes Buckup, Uwe Schweigkofler, Reinhard Hoffmann, Kay Schmidt-Horlohé
PURPOSE: To date, there has been no study investigating the epidemiology and the changes over time, especially regarding indications, in total elbow replacement in Germany. METHODS: Using German procedure classification system (OPS) codes as well as the associated ICD codes, a retrospective analysis from 2005 to 2014 of the data provided by the Federal Statistical Office of Germany was performed. Total elbow arthroplasties (TEAs) were evaluated for admitting diagnoses, sex, and age of patient and distribution of constraint versus unconstraint prostheses...
February 8, 2018: International Orthopaedics
Brian C Werner, Alexandra C Wong, Gregory T Mahony, Edward V Craig, David M Dines, Russell F Warren, Lawrence V Gulotta
INTRODUCTION: Recent biomechanical data suggests that repairing the subscapularis during reverse shoulder arthroplasty (RSA) can increase the force required by the posterior rotator cuff and deltoid to elevate the arm. METHODS: We retrospectively studied patients who underwent primary RSA and had baseline and minimum 2-year postoperative American Shoulder and Elbow Surgeons (ASES) shoulder scores, stratified them according to subscapularis management, then subgrouped them according to lateralization of the glenosphere component...
February 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
Michio Minami, Makoto Kondo, Yasuhiko Nishio, Koji Suzuki, Sadatoshi Kato, Sumito Kawamura, Hiroyuki Kato, Akio Minami
BACKGROUND: Total Elbow Arthroplasty (TEA) for the rheumatoid arthritis (RA) has been popularized since 1980s. The outcomes of TEA using any type of implant design for RA has been satisfactory. On the other hand, many orthopedicians experience several postoperative complications. Among them, postoperative infection has still being the most troublesome and difficult to treat. This study is to clarify the causes of postoperative infection of TEA using Kudo's prosthesis for RA and discuss how to manage and prevent infection...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Charalampos G Zalavras, Efthymios Papasoulis
Intra-articular fractures of the distal humerus are complex injuries that can considerably limit elbow function if not treated appropriately. Surgical management is indicated for most intra-articular distal humerus fractures with the goal of restoring elbow range of motion and function. Open reduction and internal fixation (ORIF) with plates and screws has been the preferred surgical option. Double plating is recommended for bicolumnar fractures and plates can be applied either parallel or orthogonal to each other...
February 5, 2018: International Orthopaedics
Amir R Kachooei, Nicole A M Heesakkers, Andras Heijink, Bertram The, Denise Eygendaal
BACKGROUND: Few studies have discussed the short-term results of radiocapitellar (RC) prosthetic arthroplasty (PA). In this study, we assessed the short-term to midterm functional and radiographic results of elbows after RC PA. Our secondary aim was to assess the survival of the RC PA. METHODS: We included 19 elbows in 18 patients with a mean follow-up of 35 months (range, 12-88 months). Patients were examined for instability and range of motion and were assessed using Mayo Elbow Performance Index and Oxford Elbow Score at any subsequent visits...
February 1, 2018: Journal of Shoulder and Elbow Surgery
Ryan Simovitch, Pierre-Henri Flurin, Thomas Wright, Joseph D Zuckerman, Christopher P Roche
BACKGROUND: An understanding of the substantial clinical benefit (SCB) after total shoulder arthroplasty (TSA) may help to gauge a minimum threshold beyond which a patient perceives his or her outcome as being substantially better. This study quantifies SCB for 7 outcome metrics and active motion measurements after shoulder arthroplasty and determines how these values vary based on prosthesis type, patient age at surgery, sex, and length of follow-up. METHODS: A total of 1,568 shoulder arthroplasties with 2-year minimum follow-up were performed by 13 shoulder surgeons and enrolled in a multicenter registry...
February 1, 2018: Journal of Shoulder and Elbow Surgery
Ryan M Cox, Eric M Padegimas, Joseph A Abboud, Charles L Getz, Mark D Lazarus, Matthew L Ramsey, Gerald R Williams, John G Horneff
BACKGROUND: It is common for patients to require staged bilateral shoulder arthroplasties. There is a unique cohort of patients who require an anatomic total shoulder arthroplasty (TSA) and a contralateral reverse shoulder arthroplasty (RSA). This study compared the outcomes of patients with a TSA in 1 shoulder and an RSA in the contralateral shoulder. METHODS: Our institutional database was queried to identify all patients with a TSA and a contralateral RSA. Data collection included patient demographics, preoperative and latest follow-up shoulder range of motion, radiographic analysis, and postoperative complications...
February 1, 2018: Journal of Shoulder and Elbow Surgery
Kevin C Wang, Rachel M Frank, Eric J Cotter, Annabelle Davey, Maximilian A Meyer, Charles P Hannon, Timothy Leroux, Anthony A Romeo, Brian J Cole
BACKGROUND: Microfracture is an effective surgical treatment for full-thickness cartilage defects of the knee; however, little is known regarding long-term outcomes after microfracture in the shoulder. PURPOSE: To present long-term clinical outcomes of patients undergoing microfracture of full-thickness articular cartilage defects of the glenohumeral joint. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Sixteen consecutive patients (17 shoulders) were retrospectively reviewed who underwent arthroscopic microfracture of the humeral head and/or glenoid surface, with or without additional procedures between 2001 and 2008 and with a minimum follow-up of 8...
January 1, 2018: American Journal of Sports Medicine
Andrew W Kam, Patrick H Lam, Pieter S W A Haen, Martin Tan, Aminudin Shamsudin, George A C Murrell
BACKGROUND: Brachial plexopathy is not uncommon after shoulder surgery. Although thought to be due to stretch neuropathy, its etiology is poorly understood. This study aimed to identify arm positions and maneuvers that may risk causing brachial plexopathy during shoulder arthroplasty. METHODS: Tensions in the cords of the brachial plexuses of 6 human cadaveric upper limbs were measured using load cells while each limb was placed in different arm positions and while they underwent shoulder hemiarthroplasty and revision reverse arthroplasty...
January 19, 2018: Journal of Shoulder and Elbow Surgery
Bancha Chernchujit, Renaldi Prasetia
INTRODUCTION: Tuberosity healing is known to be one of the factors that increase functional outcome in Reverse Total Shoulder Arthroplasty (rTSA). In fragility fractures, tuberosity healing is difficult to be achieved. The fragment stability and bone-forming agent application become strategies to overcome this problem. The purpose of this study was to evaluate the benefit of teriparatide application to promote tuberosity union in rTSA on four-part proximal humeral fractures to achieve better functional outcome...
January 2018: Journal of Orthopaedic Surgery
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