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Reverse shoulder arthroplasty

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https://www.readbyqxmd.com/read/28318302/isolated-subscapularis-repair-in-irreparable-posterosuperior-massive-rotator-cuff-tears-involving-the-subscapularis-tendon
#1
Sung-Jae Kim, Yun-Rak Choi, Min Jung, Won-Yong Lee, Yong-Min Chun
BACKGROUND: No previous study has examined whether isolated subscapularis tendon repair in irreparable posterosuperior massive rotator tears involving the subscapularis tendon in relatively young patients without arthritis can yield satisfactory outcomes. HYPOTHESIS: We hypothesized that this procedure would produce favorable outcomes in patients who might otherwise be candidates for reverse arthroplasty. STUDY DESIGN: Case series; Level of evidence, 4...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28304099/impact-of-shoulder-sonography-on-clinical-decision-making
#2
Michael V Friedman, Travis J Hillen, David V Holland, James M Essenberg, Jennifer L Demertzis
OBJECTIVES: To assess the impact of musculoskeletal shoulder sonography (US) on clinical decision making. METHODS: This Health Insurance Portability and Accountability Act-compliant retrospective study received Institutional Review Board approval with a waiver of informed consent. Consecutive musculoskeletal shoulder US examinations ordered over a 12-month period were retrospectively reviewed. The medical records of each patient were analyzed, recording immediate pre- and post-US treatment plans...
March 17, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28295120/geometric-analysis-of-the-proximal-humerus-in-elderly-japanese-patients-implications-for-implant-selection-in-reverse-shoulder-arthroplasty
#3
Keisuke Matsuki, Hiroyuki Sugaya, Shota Hoshika, Yusuke Ueda, Norimasa Takahashi, Morihito Tokai, Kazutomo Onishi, Scott A Banks
The implants used in reverse shoulder arthroplasty were originally designed for white patients; thus, they might not be optimal for smaller Asian patients. The selection of reverse shoulder arthroplasty systems is limited in Japan. The purpose of this study was to measure the geometry of the proximal humerus in elderly Japanese patients to inform implant selection according to humerus size. This study included 155 shoulders from 148 patients 50 years or older who underwent computed tomography for shoulder disorders other than arthritis and trauma...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28292485/a-cost-effectiveness-analysis-of-reverse-total-shoulder-arthroplasty-versus-hemiarthroplasty-for-the-management-of-complex-proximal-humeral-fractures-in-the-elderly
#4
Georg Osterhoff, Nathan N O'Hara, Jennifer D'Cruz, Sheila A Sprague, Nick Bansback, Nathan Evaniew, Gerard P Slobogean
BACKGROUND: There is ongoing debate regarding the optimal surgical treatment of complex proximal humeral fractures in elderly patients. OBJECTIVES: To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) compared with hemiarthroplasty (HA) in the management of complex proximal humeral fractures, using a cost-utility analysis. METHODS: On the basis of data from published literature, a cost-utility analysis was conducted using decision tree and Markov modeling...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28291177/long-term-outcomes-of-reverse-total-shoulder-arthroplasty-a-follow-up-of-a-previous-study
#5
Guillaume Bacle, Laurent Nové-Josserand, Pascal Garaud, Gilles Walch
BACKGROUND: Despite the increasing numbers of reverse total shoulder arthroplasty (RTSA) procedures, the long-term results have been rarely reported. We previously reported early outcomes of a cohort of patients treated with a Grammont-style RTSA. The purpose of this study was to evaluate the outcomes after a minimum of 10 years, and to document prosthetic survival and complications. METHODS: Clinical outcome assessment was based on the absolute and relative Constant scores and the active range of motion...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28286622/the-role-of-reverse-shoulder-arthroplasty-in-management-of-proximal-humerus-fractures-with-fracture-sequelae-a-systematic-review-of-the-literature
#6
REVIEW
James Holton, Tahir Yousri, George Arealis, Ofer Levy
Fracture sequelae of the proximal humerus poses a complex management decision due to the frequent deformity and its consequences on the peri-articular soft tissues. These patients are frequently elderly with significant medical comorbidities. Due to the age of the patient there is frequently rotator cuff deficiency and therefore the reverse shoulder arthroplasty (RSA) becomes the arthroplasty of choice. We have performed a systematic review of the literature and report nine studies presenting RSA for the treatment of fracture sequelae of the proximal humerus...
February 20, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28277259/comparison-of-reverse-total-shoulder-arthroplasty-outcomes-with-and-without-subscapularis-repair
#7
Richard J Friedman, Pierre-Henri Flurin, Thomas W Wright, Joseph D Zuckerman, Christopher P Roche
BACKGROUND: Repair of the subscapularis with reverse total shoulder arthroplasty (rTSA) is controversial. The purpose of this study is to quantify rTSA outcomes in patients with and without subscapularis repair to determine if there is any impact on clinical outcomes. METHODS: Three hundred forty patients received rTSA and had the subscapularis repaired, whereas 251 patients received rTSA and did not have the subscapularis repaired. The patients were scored preoperatively and at latest follow-up using the Simple Shoulder Test; University of California, Los Angeles; American Shoulder and Elbow Surgeons; Constant; and Shoulder Pain and Disability Index metrics...
October 27, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28261432/comparison-of-clinical-and-radiological-results-according-to-glenosphere-position-in-reverse-total-shoulder-arthroplasty-a-short-term-follow-up-study
#8
Chang Hyuk Choi, Sung Guk Kim, Jae Jun Lee, Byung Hoon Kwack
BACKGROUND: In a previous biomechanical study, eccentric glenospheres with more inferior position of the center of rotation were shown to improve range of motion and reduce the incidence of scapular notching after reverse total shoulder arthroplasty (RSA). The purpose of this study was to compare the clinical and radiological results of RSA using an eccentric glenosphere to those using a concentric glenosphere and to determine the usefulness of the eccentric glenosphere. METHODS: From 2009 to 2015, we performed a retrospective review of 20 consecutive patients who underwent RSA using a deltopectoral approach...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28256437/the-main-cause-of-instability-after-unconstrained-shoulder-prosthesis-is-soft-tissue-deficiency
#9
Jean Kany, Jijo Jose, Denis Katz, Jean David Werthel, Padmanaban Sekaran, Rajkumar S Amaravathi, Philippe Valenti
BACKGROUND: Instability is one of the major causes of failures in unconstrained anatomic total shoulder arthroplasty (TSA). This study reviewed the instabilities that may occur in an anatomic shoulder platform system to identify its potential predictors. We hypothesized that soft tissue deficiency was the main cause of instability and that the best treatment option would be conversion to a reverse shoulder arthroplasty (RSA). MATERIALS AND METHODS: Between 2003 and 2013, we reviewed 27 patients who experienced postoperative instability, and the overall incidence was 5...
February 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28245852/reverse-shoulder-arthroplasty-for-the-treatment-of-proximal-humeral-fractures-in-the-elderly-reshape-trial-study-protocol-for-a-multicentre-combined-randomised-controlled-and-observational-trial
#10
Geoffrey C S Smith, Ed Bateman, Ben Cass, Maurizio Damiani, Wade Harper, Hugh Jones, David Lieu, Jeff Petchell, Minas Petrelis, Kalman Piper, Doron Sher, Christopher J Smithers, John Trantalis, Sindy Vrancic, Ian A Harris
BACKGROUND: Proximal humeral fractures are common in older patients. The majority are minimally displaced and are associated with good outcomes after nonoperative treatment. Poorer outcomes are associated with displaced, multipart fractures. There is no clear benefit from surgical fracture fixation compared to nonoperative treatment. Replacement of the fractured humeral head with a hemiarthroplasty is another treatment option, but has not been shown to be clearly superior to nonoperative treatment or internal fixation...
February 28, 2017: Trials
https://www.readbyqxmd.com/read/28238965/preoperative-planning-for-accurate-glenoid-component-positioning-in-reverse-shoulder-arthroplasty
#11
Julien Berhouet, Lawrence Gulotta, David Dines, Edward Craig, Russell Warren, Daniel Choi, Xiang Chen, Andreas Kontaxis
BACKGROUND: Glenoid component positioning in reverse shoulder arthroplasty (RSA) is challenging. Patient-specific instrumentation (PSI) has been advocated to improve accuracy, and is based on precise preoperative planning. The purpose of this study was to determine the accuracy of glenoid component positioning when only the glenoid surface is visible, compared to when the entire scapula is visible on a 3D virtual model. METHODS: CT scans of 30 arthritic shoulders were reconstructed in 3D models...
February 23, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28238043/cementless-and-locked-prosthesis-for-the-treatment-of-3-part-and-4-part-proximal-humerus-fractures-prospective-clinical-evaluation-of-hemi-and-reverse-arthroplasty
#12
E Boyer, G Menu, F Loisel, R Saadnia, J Uhring, A Adam, S Rochet, P Clappaz, E Baudouin, T Lascar, R Cermeno, L Obert
INTRODUCTION: Cemented stem remains the gold standard for prosthesis in trauma. The purpose of this study was to evaluate the functional and radiological outcomes of a cementless, trauma-specific locked stem (hemi and reverse) for 3- and 4-part proximal humeral fractures. MATERIALS AND METHODS: One hundred and thirty-four 3- and 4-part fractures have been treated by locked stem, 69 with hemiarthroplasty [mean age 68 years (50-90)] and 65 with reversed [mean age 78 years (66-91)]...
February 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28217660/reverse-total-shoulder-arthroplasty-research-models
#13
Stefano Petrillo, Umile Giuseppe Longo, Lawrence V Gulotta, Alessandra Berton, Andreas Kontaxis, Timothy Wright, Vincenzo Denaro
PURPOSE: the past decade has seen a considerable increase in the use of research models to study reverse total shoulder arthroplasty (RTSA). Nevertheless, none of these models has been shown to completely reflect real in vivo conditions. METHODS: we performed a systematic review of the literature matching the following key words: "reverse total shoulder arthroplasty" or "reverse total shoulder replacement" or "reverse total shoulder prosthesis" and "research models" or "biomechanical models" or "physical simulators" or "virtual simulators"...
October 2016: Joints
https://www.readbyqxmd.com/read/28205145/is-reverse-total-shoulder-arthroplasty-a-feasible-treatment-option-for-failed-shoulder-arthroplasty-a-retrospective-study-of-44-cases-with-special-regards-to-stemless-and-stemmed-primary-implants
#14
M Holschen, B Franetzki, K-A Witt, D Liem, J Steinbeck
Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants. BACKGROUND: Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants...
February 15, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28190669/insurance-status-affects-postoperative-morbidity-and-complication-rate-after-shoulder-arthroplasty
#15
Xinning Li, David R Veltre, Antonio Cusano, Paul Yi, David Sing, Joel J Gagnier, Josef K Eichinger, Andrew Jawa, Asheesh Bedi
BACKGROUND: Shoulder arthroplasty is an effective procedure for managing patients with shoulder pain secondary to end-stage arthritis. Insurance status has been shown to be a predictor of patient morbidity and mortality. The current study evaluated the effect of patient insurance status on perioperative outcomes after shoulder replacement surgery. METHODS: Data between 2004 and 2011 were obtained from the Nationwide Inpatient Sample. Analysis included patients undergoing shoulder arthroplasty (partial, total, and reverse) procedures determined by International Classification of Disease, 9th Revision procedure codes...
February 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162887/intravenous-tranexamic-acid-reduces-total-blood-loss-in-reverse-total-shoulder-arthroplasty-a-prospective-double-blinded-randomized-controlled-trial
#16
Alexander D Vara, Denise M Koueiter, Daphne E Pinkas, Ashok Gowda, Brett P Wiater, J Michael Wiater
BACKGROUND: Patients undergoing reverse total shoulder arthroplasty (RTSA) are at risk of significant perioperative blood loss. To date, few studies have examined the effectiveness of tranexamic acid (TXA) to reduce blood loss in the setting of RTSA. METHODS: In a prospective, double-blinded, single-surgeon trial, we analyzed 102 patients undergoing primary RTSA who were randomized to receive intravenous TXA (n = 53) or placebo (n = 49). Calculated total blood loss, drain output, and hemoglobin (Hb) drop were measured...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162886/dislocation-following-reverse-total-shoulder-arthroplasty
#17
Eitan M Kohan, Peter N Chalmers, Dane Salazar, Jay D Keener, Ken Yamaguchi, Aaron M Chamberlain
BACKGROUND: The etiology of instability following reverse total shoulder arthroplasty (RTSA) remains incompletely understood. The purpose of this study was to describe the shared characteristics, etiologies, and outcomes of early and late dislocations requiring operative revision. METHODS: We identified all patients at our institution who underwent operative revision of an RTSA for instability. Baseline demographic, clinical, and radiographic data were collected...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162884/the-influence-of-three-dimensional-planning-on-decision-making-in-total-shoulder-arthroplasty
#18
Birgit S Werner, Robert Hudek, Klaus J Burkhart, Frank Gohlke
BACKGROUND: Long-term results and complication rates in shoulder arthroplasty are related to implant positioning. Current literature reports increased precision in glenoid component positioning using 3-dimensional (3D) computed tomography (CT) planning tools. This study evaluated the accuracy of glenoid version and inclination measurements using 2D CT scans compared with a validated 3D software program and its influence on decision making on implant selection. METHODS: Preoperative CT scans were obtained from 50 patients undergoing total shoulder arthroplasty...
February 2, 2017: Journal of Shoulder and Elbow Surgery
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
#19
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/28162877/humeral-version-in-reverse-shoulder-arthroplasty-affects-impingement-in-activities-of-daily-living
#20
Andreas Kontaxis, Xiang Chen, Julien Berhouet, Daniel Choi, Timothy Wright, David M Dines, Russell F Warren, Lawrence V Gulotta
BACKGROUND: Impingement after reverse shoulder arthroplasty (RSA) has been correlated with implant design and surgical techniques. Previous studies suggested that humeral retroversion can reduce impingement and increase external rotation range of motion (ROM). The purpose of this study was to determine how humeral version affects impingement in activities of daily living (ADLs). MATERIALS AND METHODS: A single surgeon performed virtual RSA on 30 arthritic shoulders that were reconstructed from preoperative computed tomography scans...
February 2, 2017: Journal of Shoulder and Elbow Surgery
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