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https://www.readbyqxmd.com/read/29138871/revision-shoulder-arthroplasty-with-a%C3%A2-reverse-shoulder-prosthesis-use-of-structural-allograft-for-glenoid-bone-loss
#1
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...
November 14, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29135662/reverse-shoulder-arthroplasty-for-the-treatment-of-rotator-cuff-deficiency-a-concise-follow-up-at-a-minimum-of-10-years-of-previous-reports
#2
Derek J Cuff, Derek R Pupello, Brandon G Santoni, Rachel E Clark, Mark A Frankle
We previously evaluated 94 patients (96 shoulders) who underwent reverse shoulder arthroplasty using a central compressive screw with 5.0-mm peripheral locking screws for baseplate fixation and a center of rotation lateral to the glenoid as treatment for end-stage rotator cuff deficiency. The purpose of this study was to report updated results at a minimum follow-up of 10 years. Forty patients (42 shoulders) were available for clinical follow-up. In the patients available for study, implant survivorship, with the end point being revision for any reason, was 90...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29133073/comparing-daily-shoulder-motion-and-frequency-after-anatomic-and-reverse-shoulder-arthroplasty
#3
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/29132328/posterior-shoulder-dislocation-with-associated-reverse-hill-sachs-lesion-treatment-options-and-functional-outcome-after-a-5-year-follow-up
#4
Markus Guehring, Simon Lambert, Ulrich Stoeckle, Patrick Ziegler
BACKGROUND: The current study describes several surgical techniques for the treatment of the reverse Hill - Sachs lesion after posterior shoulder dislocation; we also aimed to present long term results followed for a minimum of five years. METHODS: This study is a prospective case series of 17 patients who were treated in our clinic between 2008 and 2011. Patients with a defect size smaller than 25% of the articular surface were treated conservatively. An endoprosthesis of the glenohumeral joint was implanted in patients with a defect size bigger than 40%...
November 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29130873/influence-of-body-mass-index-on-clinical-outcomes-in-reverse-total-shoulder-arthroplasty
#5
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
https://www.readbyqxmd.com/read/29125820/rafting-technique-without-bone-grafting-in-reverse-hill-sachs-lesions
#6
Meriç Çırpar, Birhan Oktaş, Bülent Dağlar
In this article, we report a case of bilateral posterior shoulder instability, having reverse Hill-Sachs lesions of 25 to 50% of the articular surface on the right side, and of 50% on the left side. The defects were anatomically reconstructed after tuberculum minus osteotomy by elevation of the articular surface and buttressing with raft screws without graft usage. Early rehabilitation with pendulum shoulder exercises was started at third postoperative day. At postoperative sixth week, patient had full range of motion without instability and pain...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29124296/-diagnostics-and-treatment-of-posterior-shoulder-instability
#7
REVIEW
M Wellmann, M-F Pastor, T Smith
Posterior shoulder instability has a markedly lower incidence than anterior shoulder instability. It has a wide spectrum of clinical symptom manifestations and the overwhelming number of patients lack a traumatic primary dislocation. In addition to a detailed medical history, a specific clinical examination with the help of standardized provocation tests is essential for the diagnostics. For the detection of structural posterior capsule and labral lesions in cases of chronic courses, magnetic resonance imaging (MRI) should be used with an intra-articular contrast agent...
November 9, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29111467/reverse-shoulder-arthroplasty-in-weight-bearing-shoulders-of-wheelchair-dependent-patients
#8
Eduard Alentorn-Geli, Nathan R Wanderman, Andrew T Assenmacher, Joaquín Sánchez-Sotelo, Robert H Cofield, John W Sperling
BACKGROUND: Wheelchair-dependent patients rely on their upper extremities for mobility and transfers. This entails the heavy use of upper extremities as weight-bearing joints, leading to shoulder overuse with increased prevalence of rotator cuff-related disorders, and ultimately to challenging cases for shoulder surgeons when a joint replacement is needed. OBJECTIVE: To report the outcomes of reverse shoulder arthroplasty (RSA) in wheelchair-dependent patients with arthritis and rotator cuff tears...
October 27, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29108858/increased-expression-of-type-1-cannabinoid-cb1-receptor-among-patients-with-rotator-cuff-lesions-and-shoulder-stiffness
#9
Shu-Jui Kuo, Feng-Sheng Wang, Jih-Yang Ko, Chih-Hsin Tang, Ka-Kit Siu, Ya-Hung Hsu, Tsai-Chen Tsai
BACKGROUND: Shoulder stiffness is a disease manifested by pain, limited range of motion, and functional disability. The inflammatory and fibrosis processes play a substantial role in the pathogenesis of shoulder stiffness. The CB1 receptor has been recognized to mediate the processes of pathologic fibrosis. This study investigated the role of the CB1 pathway in pathogenesis of rotator cuff lesions with shoulder stiffness. METHODS: All of the patients undergoing repair surgery for rotator cuff lesions were recruited and subcategorized into subjects with and without shoulder stiffness...
November 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29103059/fatty-degeneration-of-the-deltoid-muscle-associated-with-displaced-proximal-humerus-fractures
#10
M Panzica, J Brandes, U Schmiddem, A Karch, N Hawi, C Krettek, R Meller
INTRODUCTION: The use of reverse shoulder arthroplasty (RSA) has increased dramatically over the last two decades, with many surgeons now indicating RSA for the acute management of displaced proximal humerus fractures (PHF) in the elderly. RSA relies on adequate deltoid muscle function to obtain a good outcome, yet no literature to date exists which discusses preoperative assessment of deltoid structure prior to RSA. The purpose of this study was to assess for preoperative fatty deltoid-degeneration in patients with displaced PHF...
October 23, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29099896/reverse-shoulder-arthroplasty-and-latissimus-dorsi-tendon-transfer
#11
Mihir Sheth, Jia-Wei Kevin Ko, Surena Namdari
In a systematic review, we critically examined and synthesized the results of individual studies on reverse shoulder arthroplasty (RSA) with latissimus dorsi tendon transfer. Two electronic databases were searched. For each included study, 2 reviewers evaluated the quality of its methods and retrieved data. In cases in which outcomes data were similar between studies, data were pooled using frequency-weighted (FW) mean values to generate summary outcomes. Seven studies met the inclusion and exclusion criteria, and 133 patient cases were reviewed...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29098356/large-diaphyseal-incorporating-allograft-prosthetic-composites-when-how-and-why-treatment-of-advanced-proximal-humeral-bone-loss
#12
REVIEW
P B McLendon, J L Cox, M A Frankle
BACKGROUND: Proximal humeral bone loss in shoulder arthroplasty is a complex problem with a heterogeneous presentation. Different etiologies may contribute to varying degrees of severity in bone loss that dictate different treatment approaches. OBJECTIVES: The purpose of this is article is to describe our technique for treatment of proximal humeral bone loss with proximal humeral allograft prosthetic composites (APC) and identify factors that may predict when larger allografts may be necessary...
November 2, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29098355/superior-glenoid-inclination-and-glenoid-bone-loss-definition-assessment-biomechanical-consequences-and-surgical-options
#13
REVIEW
L Favard, J Berhouet, G Walch, J Chaoui, C Lévigne
Correct anatomical alignment of the glenoid component is of central importance for wear and loosening in shoulder endoprostheses. The aim of this article is to review and clarify the biomechanical and clinical effects of incorrect glenoid inclination in reverse and anatomical joint replacements. Based on the literature and on our own work, statements are made about the following: (1) the glenoid inclination of a normal glenoid, a degenerative glenoid and a glenoid implant, and the consequences if superior inclination is too large, and (2) the surgical technique as well as tips and tricks for correct adjustment of the inclination...
November 2, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29083358/the-smr-reverse-shoulder-arthroplasty-in-rotator-cuff-arthropathy-management
#14
Alessandro Beltrame, Paolo Di Benedetto, Daniele Salviato, Giuseppe Niccoli, Renato Gisonni, Vanni Cainero, Araldo Causero
BACKGROUND AND AIM OF THE WORK: Cuff tear arthropathy (CTA) is a well-defined  degenerative pathology  of the shoulder. When conservative treatments are unable to permit a good quality of life, the reverse shoulder arthroplasty (RSA) can guarantee a good restitution of range of motion, function and strength of the shoulder without pain. In this paper we show our clinical, functional and radiological outcomes, as well as complications of RSA in patients with CTA. METHODS: We analyzed 31 patients who underwent to reverse shoulder replacement with Modular Shoulder System (SMR, Systema Multiplana Randelli; Lima-LTO, San Daniele del Friuli, Italy) reverse shoulder system, between August 2010-July 2014...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29079910/the-effect-of-rotator-cuff-malreduction-on-tendon-tension-an-evaluation-of-a-custom-made-digital-tensiometer-clamp
#15
Marc-Frederic Pastor, Manuel Kraemer, Michael Schwarze, Christof Hurschler, Tomas Smith, Mathias Wellmann
INTRODUCTION: Rotator cuff tears are common and good-to-excellent clinical outcome is reported after subsequent repair. However, the retear rate of rotator cuff repairs has been shown to be as high as 20%. The reasons for retear seem to be multifactorial, mainly comprised by mechanical and biological aspects. Regarding mechanical causes, the role of the tendon tension and malreduction is so far unknown. First, we hypothesized that the tendon tension depends on the technique of tendon reposition and that malreduction of the tendon results in an increased tendon tension...
October 27, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29064032/-shoulder-dislocations-in-elderly-patients
#16
REVIEW
N Hawi, D Ratuszny, E Liodakis, M Omar, C Krettek, R Meller
In contrast to shoulder dislocations in younger patients, anterior shoulder dislocation in the elderly is often associated with concomitant injuries to the rotator cuff and fractures. There is also frequent involvement of the brachial plexus or peripheral nerves. After closed reduction and a short period of immobilization, physiotherapy should be performed to restore mobility and strength. The evaluation of the rotator cuff is essential for further treatment decisions. The majority of patients are classically treated conservatively...
October 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29063283/-prosthesis-replacement-in-periprosthetic-humeral-fractures
#17
REVIEW
M Jaeger, D Maier, K Izadpanah, N P Südkamp
OBJECTIVE: Stabilization of the humerus with preservation or restoration of the shoulder function. INDICATIONS: Always in the presence of a loose prosthesis. It may become necessary in conditions of poor bone stock and if osteosynthesis is not possible. CONTRAINDICATIONS: Noncompliant patients due to alcohol or drugs. Local infections. SURGICAL TECHNIQUE: The loose implant is removed using an extended anterior deltopectoral approach...
October 23, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29063145/-humeral-and-glenoid-bone-loss-in-shoulder-arthroplasty-classification-and-treatment-principles
#18
REVIEW
F Gohlke, B Werner
TECHNIQUE: The treatment of bone defects in primary shoulder arthroplasty has evolved due to more detailed diagnostic tools, 3D planning and expanded indications for reverse shoulder arthroplasty. Glenoid bone defects combined with chronic posterior subluxation of the humeral head are gradually being treated by glenoid reconstruction and reverse implants even if the rotator cuff is still intact. The treatment of advanced bone loss due to glenoid loosening has been facilitated by bone augmentation using a cementless fixation as proposed by Norris...
October 23, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29058754/partial-resurfacing-for-humeral-head-defects-associated-with-recurrent-shoulder-instability
#19
Matthew C Bessette, Nicholas C Frisch, Pradeep Kodali, Morgan H Jones, Anthony Miniaci
Recurrent traumatic shoulder instability is a complex clinical entity that commonly affects young, active patients. Humeral head defects are frequently associated with this condition, but specific treatment to stabilize the shoulder is rarely needed. Management options for defects of the humeral head that do necessitate treatment carry various risks and disadvantages, including the need for bone or soft tissue healing, complications related to hardware, and loss of motion. Partial prosthetic resurfacing has been reported as a treatment option...
October 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29058027/-results-from-the-german-shoulder-and-elbow-arthroplasty-register-sepr-anatomic-or-reverse-shoulder-arthroplasty-in-b2-glenoids
#20
P Magosch, P Habermeyer, S Lichtenberg, M Tauber, F Gohlke, F Mauch, D Boehm, M Loew, F Zeifang, W Pötzl
BACKGROUND: Anatomic shoulder arthroplasty in osteoarthritis with biconcave glenoid wear results in decreased functional results and a higher rate of early glenoid loosening. AIM: The aim of the data analysis of the German shoulder arthroplasty register was to clarify whether reverse shoulder arthroplasty can provide better functional results and a lower complication rate than anatomic arthroplasty in osteoarthritis with biconcave glenoid wear. METHODS: The analysis included 1052 completely documented primary implanted arthroplasties with a minimum follow-up of 2 years...
October 20, 2017: Der Orthopäde
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