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Total shoulder arthroplasty

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https://www.readbyqxmd.com/read/29238824/effect-of-perioperative-gabapentin-on-postoperative-pain-resolution-and-opioid-cessation-in-a-mixed-surgical-cohort-a-randomized-clinical-trial
#1
Jennifer Hah, Sean C Mackey, Peter Schmidt, Rebecca McCue, Keith Humphreys, Jodie Trafton, Bradley Efron, Debra Clay, Yasamin Sharifzadeh, Gabriela Ruchelli, Stuart Goodman, James Huddleston, William J Maloney, Frederick M Dirbas, Joseph Shrager, John Costouros, Catherine Curtin, Ian Carroll
Importance: Guidelines recommend using gabapentin to decrease postoperative pain and opioid use, but significant variation exists in clinical practice. Objective: To determine the effect of perioperative gabapentin on remote postoperative time to pain resolution and opioid cessation. Design, Setting, and Participants: A randomized, double-blind, placebo-controlled trial of perioperative gabapentin was conducted at a single-center, tertiary referral teaching hospital...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29224946/revision-arthroplasty-of-the-wrist-in-patients-with-rheumatoid-arthritis-mean-follow-up-6-6-years
#2
Per Fischer, Marcus Sagerfors, Ole Brus, Kurt Pettersson
PURPOSE: Management of failed total wrist arthroplasty (TWA) can be challenging; surgical treatment options include salvage arthrodesis, revision arthroplasty, and resection arthroplasty. There are few studies regarding salvage arthrodesis, and revision arthroplasty has been infrequently investigated. The aim of the study was to report the outcome after revision arthroplasty of the wrist. METHODS: A retrospective cohort of 16 revision TWAs was evaluated between 2003 and 2016...
December 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29223321/is-there-value-in-retrospective-90-day-bundle-payment-models-for-shoulder-arthroplasty-procedures
#3
Susan M Odum, Nady Hamid, Bryce A Van Doren, Leo R Spector
BACKGROUND: The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative was implemented as part of the Affordable Care Act. We implemented a retrospective payment model 2 for a 90-day total shoulder arthroplasty (TSA) episode to assess the value of TSA BPCI at our private practice. METHODS: Expenditures and postacute event rates of 132 fee-for-service (FFS) patients who underwent a TSA operation between 2009 and 2012 were compared with 333 BPCI patients who had a TSA operation in 2015...
December 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29214382/bleeding-in-primary-shoulder-arthroplasty
#4
Dominik Malcherczyk, Asma Abdelmoula, Thomas J Heyse, Christian D Peterlein, Brandon Greene, Bilal F El-Zayat
INTRODUCTION: The aim of this investigation was to analyse "total blood loss" (TBL), "blood transfusion rate" (BT) and the "amount of transfused blood units" (BU) between the different primary shoulder arthroplasty (SA) types: reverse, anatomical and stemless. Only primary SA was included. Further goal was to identify risk factors for TBL, amount of BU and BT rate. METHODS: A retrospective charts analysis of patients who received primary SA for degenerative shoulder pathology in our institution between 2004 and 2016 was performed...
December 6, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29204822/the-experience-of-the-ripo-a-shoulder-prosthesis-registry-with-6-year-follow-up
#5
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
https://www.readbyqxmd.com/read/29198353/editorial-commentary-when-the-shoulder-joint-has-lost-stoichiometry-does-arthroscopic-assisted-latissimus-dorsi-transfer-stack-up
#6
EDITORIAL
Robert D Graham
Non-arthroplasty treatment options for pseudoparalysis of the shoulder are preferable in the younger patient population. Although there are differing philosophies among shoulder surgeons, many prefer to avoid reversed total shoulder arthroplasty for patients under age 60 years. Arthroscopically assisted latissimus dorsi transfer may be a good alternative for these patients, but how the results compare with arthroscopic superior capsular reconstruction is the question.
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29196384/trends-in-joint-replacement-surgery-in-patients-with-rheumatoid-arthritis
#7
Bradley L Young, Shawna L Watson, Jorge L Perez, Gerald McGwin, Jasvinder A Singh, Brent A Ponce
OBJECTIVE: This study analyzed trends in large total joint arthroplasties (TJA) and in the proportion of these procedures performed on patients with rheumatoid arthritis (RA). METHODS: The US Nationwide Inpatient Sample (2002-2012) was used to identify the incidences of total shoulder (TSA), elbow (TEA), knee (TKA), hip (THA), and ankle (TAA) arthroplasty and the proportion of these performed with coexisting RA. RESULTS: The prevalence of RA among patients with TJA increased 3...
December 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29195900/outcomes-for-subscapularis-management-techniques-in-shoulder-arthroplasty-a-systematic-review
#8
REVIEW
W Stephen Choate, Adam Kwapisz, Amit M Momaya, Richard J Hawkins, John M Tokish
BACKGROUND: This systematic review aims to synthesize published data for the most common subscapularis takedown and repair to compare outcomes in the setting of shoulder arthroplasty. METHODS: Searches of MEDLINE and Cochrane Library databases identified studies that reported clinical or radiologic outcomes for subscapularis management in the setting of shoulder arthroplasty. Comparisons included musculotendinous integrity, subscapularis testing and strength, shoulder range of motion, and functional outcome scores...
November 28, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29162305/quantifying-success-after-total-shoulder-arthroplasty-the-minimal-clinically-important-difference
#9
Ryan Simovitch, Pierre-Henri Flurin, Thomas Wright, Joseph D Zuckerman, Christopher P Roche
BACKGROUND: Knowledge of the minimal clinically important difference (MCID) for different shoulder outcome metrics and range of motion after total shoulder arthroplasty (TSA) can be useful to establish a minimum threshold of improvement that defines successful treatment. This study quantifies how MCID varies with different prosthesis types, patient age, gender, and length of follow-up after TSA. METHODS: A total of 466 anatomic TSA (aTSA) and reverse TSA (rTSA) with 2-year minimum follow-up were performed by 13 shoulder surgeons...
November 18, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29162072/functional-midterm-follow-up-comparison-of-stemless-total-shoulder-prostheses-versus-conventional-stemmed-anatomic-shoulder-prostheses-using-a-3d-motion-analysis
#10
David M Spranz, Hendrik Bruttel, Sebastian I Wolf, Felix Zeifang, Michael W Maier
BACKGROUND: The aim of this study is to compare the functional midterm outcome of stemless shoulder prostheses with standard anatomical stemmed shoulder prostheses and to show that the STEMLESS results are comparable to the STEMMED with respect to active maximum range of shoulder motion (ROM) and Constant score (CS). METHODS: Seventeen patients underwent total shoulder arthroplasty (TSA) in 25 shoulder joints. Stemless TSA was performed in 12 shoulder joints (group STEMLESS), third-generation stemmed TSA in 13 shoulder joints (group STEMMED)...
November 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29155311/glenoid-exposure-in-total-shoulder-arthroplasty
#11
REVIEW
L Nové-Josserand, P Clavert
Glenoid exposure is agreed to be a difficult step, but is also a key step in total shoulder arthroplasty, both anatomic and reverse. It conditions unhindered use of the ancillary instrumentation and thus correct glenoid component positioning. The main stages comprise arthrotomy, by opening the rotator cuff, humeral head cut, and inferior glenohumeral release, enabling shifting of the humerus and good exposure of the glenoid cavity. The two main approaches are deltopectoral and anterosuperior transdeltoid. Using the deltopectoral approach, arthrotomy is performed through the subscapularis muscle, by various techniques...
November 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29152008/short-medium-and-long-term-complications-after-total-anatomical-shoulder-arthroplasty
#12
REVIEW
T M Gregory, B Boukebous, J Gregory, J Pierrart, E Masemjean
Total shoulder arthroplasty (TSA) is an effective approach for the treatment of a variety of clinical conditions affecting the shoulder, including osteoarthritis, inflammatory arthritis and osteonecrosis, and the number of TSA implanted has grown exponentially over the past decade. This review gives an update of the major complications, mainly infections, instability and loosening, encountered after TSA, based on a corpus of recent publications and a dynamic approach: The review focuses on the causes of glenoid loosening, which account for 80% of the complication, and underlines the importance of glenoid positioning in the recovery of early shouder function and in the long term survival rate of TSA...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29152007/shoulder-arthroplasty-imaging-what-s-new
#13
REVIEW
T M Gregory, J Gregory, E Nicolas, J Pierrart, E Masmejean
Background: Shoulder arthroplasty, in its different forms (hemiarthroplasty, total shoulder arthroplasty and reverse total shoulder arthroplasty) has transformed the clinical outcomes of shoulder disorders. Improvement of general clinical outcome is the result of stronger adequacy of the treatment to the diagnosis, enhanced surgical techniques, specific implanted materials, and more accurate follow up. Imaging is an important tool in each step of these processes. Method: This article is a review article declining recent imaging processes for shoulder arthroplasty...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29152006/anatomic-shoulder-arthroplasty-technical-considerations
#14
REVIEW
Bogdan A Matache, P Lapner
Osteoarthritis of the shoulder is a common condition in the aging population, and it can have profound effects on patients' quality of life. The anatomic total shoulder arthroplasty is a well-described treatment modality resulting generally excellent outcomes. The objective of this review is to discuss the technical aspects of primary anatomic total shoulder arthroplasty, and to provide a framework to follow to achieve a successful surgical result. The topics covered include preoperative planning, surgical considerations, and approaches, humeral preparation, glenoid bone loss and the emerging concept of using the reverse total shoulder arthroplasty for the type B2 glenoid...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29145989/pain-management-strategies-in-shoulder-arthroplasty
#15
REVIEW
Jason L Codding, Charles L Getz
Pain control in total shoulder arthroplasty demands a multidisciplinary approach with collaboration between patients, surgeon, and anesthetist. A multimodal approach with preemptive medication, regional blockade, local anesthetics, and a combination of acetaminophen, nonsteroidal antiinflammatory drugs, tramadol, and gabapentinoids postoperatively leads to pain control and patient satisfaction. Assessment of patients' expectations constitutes a vital aspect of the preoperative patient evaluation. Educating and psychologically preparing patients reduces postoperative pain...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29141613/determinants-of-patient-satisfaction-following-reconstructive-shoulder-surgery
#16
Sascha J Baettig, Karl Wieser, Christian Gerber
BACKGROUND: Obtaining patient satisfaction is a key goal of surgical treatment. It was the purpose of this study to identify pre-, peri- and postoperative factors determining patient satisfaction after shoulder surgery, quantify their relative importance and thereby allow the surgeon to focus on parameters, which will influence patient satisfaction. METHODS: We retrospectively reviewed 505 patients, who underwent either rotator cuff repair (n = 216) or total shoulder arthroplasty (n = 289)...
November 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29138871/revision-shoulder-arthroplasty-with-a%C3%A2-reverse-shoulder-prosthesis-use-of-structural-allograft-for-glenoid-bone-loss
#17
S E Ozgur, R Sadeghpour, T R Norris
INTRODUCTION: Revision shoulder arthroplasty presents many unique and complex challenges when glenoid bone loss is involved. A distorted and medialized anatomy prevents the proper mechanics of the reverse prosthesis with regard to deltoid tension and ultimate function. This paper highlights one surgeon's experience using structural allograft for glenoid bone loss. PATIENTS AND METHODS: In all, 20 patients for a total of 24 surgeries with a medialized glenoid and/or substantial glenoid bone loss of grade IIB or higher were evaluated in this retrospective study...
December 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29135529/acute-coronary-artery-thrombus-after-tranexamic-acid-during-total-shoulder-arthroplasty-in-a-patient-with-coronary-stents-a-case-report
#18
Kathryn H Bridges, Sylvia H Wilson
Tranexamic Acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29133073/comparing-daily-shoulder-motion-and-frequency-after-anatomic-and-reverse-shoulder-arthroplasty
#19
G Daniel G Langohr, John P Haverstock, James A Johnson, George S Athwal
BACKGROUND: Both anatomic (TSA) and reverse total shoulder arthroplasty (RTSA) are common interventions for glenohumeral arthrosis, with the goal of relieving pain and restoring mobility. Understanding shoulder arthroplasty motion and frequency is of interest in evaluating effectiveness and in predicting bearing wear for implant development and optimization. The purpose of this study was to measure and compare the total daily shoulder motion of patients after TSA and RTSA. METHODS: Thirty-six human subjects who had undergone shoulder arthroplasty wore a custom instrumented garment that tracked upper extremity motion for the waking hours of 1 day...
November 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29130873/influence-of-body-mass-index-on-clinical-outcomes-in-reverse-total-shoulder-arthroplasty
#20
J Michael Wiater, Shannon Carpenter, Denise M Koueiter, David Marcantonio, Brett P Wiater
The purpose of this study was to compare reverse total shoulder arthroplasty (RTSA) outcomes in normal weight, overweight, and obese patients. A RTSA outcomes registry was reviewed for rotator cuff-deficient patients with a minimum 2-year follow-up. Fractures, rheumatoid arthritis, and revisions were excluded. Based on World Health Organization body mass index (BMI) classification, there were 29 normal weight, 50 overweight, and 51 obese patients. All groups demonstrated significant improvements from preoperative to most recent follow-up in function scores, pain, and forward elevation...
October 2017: Journal of Surgical Orthopaedic Advances
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