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Reverse shoulder arthroplasty

Andrew T Koogler, Michael Kushelev
A 76-year-old male presented for reverse total shoulder arthroplasty (TSA) in the beach chair position. A preoperative interscalene nerve catheter was placed under direct ultrasound-guidance utilizing a posterior in-plane approach. On POD 2, the catheter was removed. Three weeks postoperatively, the patient reported worsening dyspnea with a subsequent chest X-ray demonstrating an elevated right hemidiaphragm. Pulmonary function testing revealed worsening deficit from presurgical values consistent with phrenic nerve palsy...
2018: Case Reports in Anesthesiology
T Patzer
BACKGROUND: In a progredient rotator cuff tear with tendon retraction, fatty infiltration and atrophy of rotator cuff muscles the humerus cannot be centered and stabilized sufficiently in the glenohumeral joint. This leads to rotator cuff defect arthropathy as an eccentric osteoarthritis with acetabularization and wear of the acromion, as well as of the glenoid. INDICATION: A painful pseudoparalysis of the shoulder indicates the implantation of a reversed total shoulder arthroplasty (rTSA) to reduce pain and restore active motion...
March 7, 2018: Der Orthopäde
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
O Lorbach
IMPLANT DESIGNS: Within the last 50 years, implants for shoulder replacement have developed rapidly. Monobloc-stems in few sizes were changed to modular implant systems that allow for an individual adaption of the stem, as well as adaption of the humeral head component according to the specific anatomic situation of the patient. Moreover, stemless und short stem implants are available, which may highly simplify primary implantation, especially in posttraumatic cases as well as in revision cases with a need for removal or change of the implants...
March 6, 2018: Der Orthopäde
O Verborgt, A I Hachem, K Eid, Kd Vuylsteke, M Ferrand, P Hardy
BACKGROUND: The aim of this study was to assess the accuracy of patientspecific guided glenoid component implantation in reverse shoulder arthroplasty MATERIALS AND METHODS: 32 reverse shoulder arthroplasties were done using pre-operative 3D planning and 4 patient-specific guides to prepare the glenoid and position the glenoid component. Baseplate version, inclination and entry point as well as angulation of the screws were compared to the pre-operative plan measured on CT by independent observers...
March 2, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Michael Livesey, John G Horneff, Daniel Sholder, Mark Lazarus, Gerald Williams, Surena Namdari
A well-functioning rotator cuff is necessary for successful anatomic total shoulder arthroplasty (TSA). This study evaluated patients who underwent concomitant TSA and rotator cuff repair (RCR) for functional outcomes, revision rates, and predictors of poor results. Retrospective chart review was conducted to identify patients who underwent TSA and RCR. Demographic data, rotator cuff tear and RCR characteristics, range of motion, and radiographs were recorded. Minimum 2-year functional outcomes were obtained...
March 1, 2018: Orthopedics
Brian E Ward, Joshua S Dines
Optimal outcomes following total shoulder arthroplasty TSA and reverse shoulder arthroplasty RSA are dependent on proper implant position. Multiple cadaver studies have demonstrated improved accuracy of implant positioning with use of patient-specific guides/instrumentation compared to traditional methods. At this time, there are 3 commercially available single use patient-specific instrumentation systems and 1 commercially available reusable patient-specific instrumentation system. Currently though, there are no studies comparing the clinical outcomes of patient-specific guides to those of traditional methods of glenoid placement, and limited research has been done comparing the accuracy of each system's 3-dimensional planning software...
February 2018: American Journal of Orthopedics
Philippe Valenti, Denis Katz, Jean Kany, Jean-David Werthel
Removal of a cemented glenoid component often leads to massive glenoid bone loss, which makes it difficult to implant a new glenoid baseplate. The purpose of this study was to demonstrate the feasibility of revisions with a completely convertible system and to report clinical and radiographic results of a retrospective review of 13 cases. Between 2003 and 2011, 104 primary total shoulder arthroplasties (TSAs) were performed with an uncemented glenoid component in our group. Of these patients, 13 (average age, 64 years) were revised to reverse shoulder arthroplasty (RSA) using a modular convertible platform system and were included in this study...
February 2018: American Journal of Orthopedics
Alexandre Lädermann, Patrick J Denard, Pascal Boileau, Alain Farron, Pierric Deransart, Gilles Walch
PURPOSE: The purpose of this study was to analyze the effect of different glenoid configurations on arm position and range of motion (ROM) following reverse shoulder arthroplasty (RSA). The hypothesis was that different glenoid configurations would lead to changes in humeral offset, acromio-humeral distance (AHD), ROM, and rotator cuff muscle length. METHODS: Using a three-dimensional (3D) computer model, implantation of an RSA was simulated with a 145° onlay humeral stem combined with five different glenoid configurations which varied in diameter and centre of rotation...
February 28, 2018: International Orthopaedics
Carlos Torrens, Eduard Alentorn-Geli, Felipe Mingo, Carlo Gamba, Fernando Santana
PURPOSE: To investigate the influence of greater tuberosity healing on the functional outcomes of reverse shoulder arthroplasty (RSA) for the treatment of acute complex proximal humeral fractures (PHFs), and to investigate the influence of patient- and surgery-related factors in the healing of the greater tuberosity. METHODS: Retrospective study including 41 consecutive PHFs treated using RSA with minimum 2-year follow-up. In all the cases, tuberosities were reattached with a standardized technique...
January 2018: Journal of Orthopaedic Surgery
Yaiza Lopiz, Alberto Rodriguez-González, Susana Martín-Albarrán, Hector Marcelo, Carlos García-Fernández, Fernando Marco
BACKGROUND: Neurologic pre- and postoperative injuries to the axillary and/or suprascapular nerve (SSN) have a higher incidence than expected and may lead to significantly decreased functional outcomes and increased risk of reverse shoulder arthroplasty (RSA) failure. METHODS: Patients who underwent a RSA for rotator cuff tear arthropathy (RCTA) were included from December 2014 to December 2015. This study focused on the clinical (Constant score), radiographic, and pre- and postoperative electromyographic evaluations at 3 and 6 months...
February 20, 2018: Journal of Shoulder and Elbow Surgery
Matthew D Williams, Thomas Bradley Edwards, Gilles Walch
Although the teres minor is often overlooked in a normal shoulder, it becomes a key component in maintaining shoulder function when other rotator cuff tendons fail. The teres minor maintains a balanced glenohumeral joint and changes from an insignificant to the most significant external rotator in the presence of major rotator cuff pathology. The presence or absence of the teres minor provides prognostic information on the outcomes of reverse total shoulder arthroplasty and tendon transfers. Clinical tests include the Patte test, the Neer dropping sign, the external rotation lag sign, and the Hertel drop sign...
March 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
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
Liang-Tseng Kuo, Wei-Hsiu Hsu, Ching-Chi Chi, Jae Chul Yoo
BACKGROUND: The effects of tranexamic acid (TXA) in the setting of shoulder arthroplasty are unclear. The objective of this study was to examine the effects of TXA in reducing the need for blood transfusions and blood loss in patients undergoing primary total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA). METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and retrospective cohort studies (RCS) that compared outcomes of patients who did and did not receive TXA during TSA or RTSA...
February 17, 2018: BMC Musculoskeletal Disorders
Derek J Cuff, Brandon G Santoni
This retrospective review evaluated the mid-term outcomes of cemented reverse shoulder arthroplasty in patients who use the shoulder for weight bearing (WB) vs non-weight-bearing (NWB) patients. Twenty-five shoulders of 21 patients who used their upper extremity for WB (WB group) were treated with cemented reverse shoulder arthroplasty and followed for a minimum of 5 years postoperatively (average, 73 months). Seventy-five consecutive shoulders of 72 patients who were NWB (NWB group) were treated and matched for duration of follow-up (average, 72 months) to serve as a control group...
February 16, 2018: Orthopedics
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
Joey LaMartina, Kaitlyn N Christmas, Peter Simon, Jonathan J Streit, Jesse W Allert, Jonathan Clark, Randall J Otto, Adham Abdelfattah, Mark A Mighell, Mark A Frankle
BACKGROUND: Decision making in the management of proximal humerus fractures can be difficult in situations in which the surgeon is uncertain of the ideal treatment. METHODS: Two shoulder surgeons operatively treated 476 proximal humerus fractures from 1998-2014 with open reduction-internal fixation (ORIF), hemiarthroplasty, or reverse shoulder arthroplasty. Operative treatment was stratified by year to determine the evolution of technological influences on treatment over time...
March 2018: Journal of Shoulder and Elbow Surgery
Aaron M Chamberlain
No abstract text is available yet for this article.
February 8, 2018: Clinical Orthopaedics and related Research
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
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
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