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https://www.readbyqxmd.com/read/28594497/arthroplasty-for-unreconstructable-acute-fractures-and-failed-fracture-fixation-about-the-hip-and-knee-in-the-active-elderly-a-new-paradigm
#1
Richard F Kyle, Paul J Duwelius, George J Haidukewych, Andrew H Schmidt
The techniques, materials, and designs for total joint arthroplasty underwent major improvements in the past 30 years. During this time, trauma surgeons classified the severity of fractures as well as identified certain articular fractures that do not have good outcomes and have a high rate of failure after internal fixation. Advanced improvements in arthroplasty have increased its reliability and longevity. Total joint arthroplasty is becoming a standard of care for some acute articular fractures, particularly displaced femoral neck fractures in the active elderly...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28590378/increasing-body-mass-index-is-associated-with-worse-outcomes-after-shoulder-arthroplasty
#2
Eric R Wagner, Matthew T Houdek, Cathy Schleck, William S Harmsen, Joaquin Sanchez-Sotelo, Robert Cofield, John W Sperling, Bassem T Elhassan
BACKGROUND: Although obesity is associated with increased complication rates after lower-extremity arthroplasty, there is a relative paucity of studies examining the effect of body mass index (BMI) on shoulder arthroplasty. The purpose of this investigation was to evaluate the effect of BMI on implant survival and the rate of complications after shoulder arthroplasty. METHODS: Using an institutional total joint registry, 4,567 consecutive shoulder arthroplasty cases from 1970 to 2013 were studied...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28588109/finnish-subacromial-impingement-arthroscopy-controlled-trial-fimpact-a-protocol-for-a-randomised-trial-comparing-arthroscopic-subacromial-decompression-and-diagnostic-arthroscopy-placebo-control-with-an-exercise-therapy-control-in-the-treatment-of-shoulder
#3
Mika Paavola, Antti Malmivaara, Simo Taimela, Kari Kanto, Teppo Ln Järvinen
INTRODUCTION: Arthroscopic subacromial decompression (ASD) is the most commonly performed surgical intervention for shoulder pain, yet evidence on its efficacy is limited. The rationale for the surgery rests on the tenet that symptom relief is achieved through decompression of the rotator cuff tendon passage. The primary objective of this superiority trial is to compare the efficacy of ASD versus diagnostic arthroscopy (DA) in patients with shoulder impingement syndrome (SIS), where DA differs only by the lack of subacromial decompression...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28583754/bilateral-bony-increased-offset-reverse-shoulder-arthroplasty-in-rheumatoid-arthritis-shoulder-with-severe-glenoid-bone-defect-a-case-report
#4
Wan-Sun Choi, Kwang-Hyun Lee, Jin-Sung Park, Bong Gun Lee
A 53-year-old woman presented with 10-year history of pain and limited range of motion in both shoulders. Radiographs of both shoulders showed severe shoulder osteoarthritis with glenoid bone defect. Very thin rotator cuff and superior migration of the humerus were also observed on computed tomography images. We performed bony increased-offset reverse total shoulder arthroplasty on her both shoulders. The patient had a good clinical outcome without any particular complication.
June 2, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28583023/safety-of-outpatient-total-ankle-arthroplasty-vs-traditional-inpatient-admission-or-overnight-observation
#5
Ryan P Mulligan, Selene G Parekh
BACKGROUND: Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control. METHODS: The medical records of patients who underwent TAA with 1 fellowship-trained orthopedic foot and ankle surgeon were reviewed...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28572846/legal-and-psychological-considerations-for-obtaining-informed-consent-for-reverse-total-shoulder-arthroplasty
#6
REVIEW
Craig Blackwood, Jen Dixon, Peter Reilly, Roger J Emery
This paper seeks to outline recent legal developments and requirements pertinent to obtaining informed consent. We argue that this is of particular relevance to patients considering a reverse total shoulder arthroplasty, due to the high complication rate associated with this procedure. By examining the cognitive processes involved in decision-making, and other clinician-related factors such as delivery of information, gender bias and conflict of interest, we explore some of the barriers that can undermine the processes of shared decision-making and obtaining genuine informed consent...
January 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28567319/anterior-interosseous-nerve-neuropraxia-secondary-to-shoulder-arthroscopy-and-open-subpectoral-long-head-biceps-tenodesis
#7
Jeremiah T Steed, Kathlyn Drexler, Adam N Wooldridge, Matthew Ferguson
Arthroscopic rotator cuff tendon repair is a common elective procedure performed by trained orthopaedic surgeons with a relatively low complication rate. Specifically, isolated neuropraxia of the anterior interosseous nerve (AIN) is a very rare complication of shoulder arthroscopy. An analysis of peer-reviewed published literature revealed only three articles reporting a total of seven cases that describe this specific complication following standard shoulder arthroscopic procedures. This article reports on three patients diagnosed with AIN neuropraxia following routine shoulder arthroscopy done by a single surgeon within a three-year period...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28567225/clinical-outcomes-and-complications-during-the-learning-curve-for-reverse-total-shoulder-arthroplasty-an-analysis-of-the-first-40-cases
#8
Chul-Hyun Cho, Kwang-Soon Song, Tae-Won Koo
BACKGROUND: The purpose of this study was to investigate the results and complications during the learning curve of reverse total shoulder arthroplasty (RTSA) for rotator cuff deficiency. METHODS: We retrospectively reviewed the first 40 cases of RTSA performed by a single surgeon. The mean age of patients was 72.7 years (range, 63 to 81 years) and mean follow-up period was 26.7 months (range, 9 to 57 months). Clinical outcomes were evaluated using a visual analog scale (VAS) for pain, the University of California at Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeon (ASES) score, subjective shoulder value (SSV), and active range of motion (ROM)...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28566402/recurrence-of-frozen-shoulder-after-manipulation-under-anaesthetic-mua-the-results-of-repeating-the-mua
#9
D A Woods, K Loganathan
AIMS: Manipulation under anaesthetic (MUA) is a recognised form of treatment for patients with a frozen shoulder. However, not all patients benefit. Some have persistent or recurrent symptoms. There are no clear recommendations in the literature on the optimal management of recurrent frozen shoulder after a MUA. We aimed to address this issue in this study. PATIENTS AND METHODS: We analysed a prospectively collected, single-surgeon, consecutive series of patients who underwent MUA for frozen shoulder between January 1999 and December 2015...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28558113/retrieval-analysis-of-porous-titanium-glenoid-posts-an-evaluation-of-osteointegration
#10
Jacob G Calcei, Julien Berhouet, Marcella Elpers, Anthony Catanzano, Timothy M Wright, Edward V Craig, Russell F Warren, David M Dines, Lawrence V Gulotta
Glenoid component loosening is a commonly encountered complication of total shoulder replacements. Therefore, focus has been placed on glenoid fixation. Porous metal implants, which promote biological fixation through osteointegration, have provided an uncemented alternative to the traditional cemented implant. In this explantation study, the authors examined the bone ingrowth and ongrowth of a specific porous titanium glenoid peg. Six explanted polyethylene glenoid components with porous titanium-coated central pegs were identified in the authors' implant retrieval program via retrospective review...
May 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28540605/characteristics-of-rheumatoid-arthritis-patients-undergoing-reverse-shoulder-arthroplasty
#11
Julio J Jauregui, J Paul Hovis, S Ashfaq Hasan
The risks and complication profile of reverse total shoulder arthroplasty (RSA) in rheumatoid arthritis (RA) patients has yet to be clearly defined as most studies have small cohorts. Using a large inpatient database, the purpose on our study was to determine the overall demographics, hospitalization characteristics, and early complication rates in rheumatoid patients and compared these to rotator-cuff arthropathy patients without RA undergoing RSA. Utilizing United States Nationwide Inpatient Sample from 2010 to 2013, we evaluated a total of 919 RA RSA and compared them to 8097 patients without RA undergoing RSA...
May 24, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28538422/chest-wall-swelling-and-pneumothorax-after-shoulder-arthroscopy-were-the-2-events-totally-independent
#12
Jong Bun Kim, Min Kyung Choi, Yong Kyoung Jeon, Jae Myeong Lee
RATIONALE: Arthroscopic shoulder surgery (ASS) is a low mortality and morbidity procedure, but anesthetic complications are reported. There have been no reports of combined chest wall swelling and pneumothorax after ASS. PATIENT CONCERNS: The patient's right lung was severely collapsed and the mediastinum was deviated after ASS. DIAGNOSIS: Pneumothorax on right chest. INTERVENTIONS: A chest tube was inserted and oxygen therapy was performed...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28512698/repair-of-the-pronator-quadratus-after-volar-plate-fixation-in-distal-radius-fractures-a-systematic-review
#13
REVIEW
Marjolein A M Mulders, Monique M J Walenkamp, Fernande J M E Bos, Niels W L Schep, J Carel Goslings
To position the volar plate on the distal radius fracture site, the pronator quadratus muscle needs to be detached from its distal and radial side and lifted for optimal exposure to the fracture site. Although the conventional approach involves repair of the pronator quadratus, controversy surrounds the merits of this repair. The purpose of this study was to compare the functional outcomes of patients with distal radius fractures treated with pronator quadratus repair after volar plate fixation versus no pronator quadratus repair...
May 17, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28504808/outcome-of-reverse-shoulder-arthroplasty-for-patients-with-parkinson-s-disease-a-matched-cohort-study
#14
Michael C Cusick, Randall J Otto, Rachel E Clark, Mark A Frankle
Parkinson's disease (PD) is a progressive neurologic disorder that affects the musculoskeletal system. Currently, the use of reverse shoulder arthroplasty (RSA) for patients with PD has not been adequately studied. The authors sought to determine if RSA provided similar functional outcomes for patients with PD compared with a matched cohort of patients without PD. Between 2004 and 2011, 10 patients with PD (4 men, 6 women) underwent RSA. Patients with PD were matched to patients without PD at a 1:4 ratio based on age (average, 76 years; range, 63-85 years), sex (16 men, 24 women), preoperative diagnosis, and length of follow-up (average, 43 months; range, 24-128 months)...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28489628/lengthening-of-newly-formed-humerus-after-autologous-fibula-graft-transplantation-following-intercalary-tumor-resection
#15
Hakan Pilge, Martin Ruppert, Bernd Bittersohl, Bettina Westhoff, Rüdiger Krauspe
Secondary limb lengthening after intercalary bone resection in pediatric patients is still challenging. After the resection, a free fibula autograft can be used to reconstruct the osseous gap. However, in particular in young pediatric patients, insufficient growth of the epiphyseal plate after transplantation may lead to a significant limb-length discrepancy (LLD). In this case, the autograft was used for limb lengthening. We report on the lengthening of a humerus regenerate after fibula autograft transplantation into a humeral defect in a pediatric/young adolescent patient...
May 5, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28483434/posterior-glenoid-bone-grafting-in-total-shoulder-arthroplasty-for-osteoarthritis-with-severe-posterior-glenoid-wear
#16
Gregory P Nicholson, Gregory L Cvetanovich, Allison J Rao, Patrick O'Donnell
BACKGROUND: Total shoulder arthroplasty (TSA) in cases with posterior wear can be addressed by eccentric reaming of the anterior glenoid or by augmenting the posterior glenoid with bone grafting or augmented glenoid implants. We report the results of TSA with posterior glenoid bone grafting (PGBG) with humeral head autograft in patients with shoulder osteoarthritis and severe posterior glenoid wear. METHODS: A retrospective review of cases from 2004 to 2014 revealed 34 patients...
May 5, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28483432/reverse-shoulder-arthroplasty-in-patients-with-os-acromiale
#17
William R Aibinder, Bradley S Schoch, Robert H Cofield, John W Sperling, Joaquin Sánchez-Sotelo
BACKGROUND: Os acromiale has been reported in up to 15% of the general population. Reverse total shoulder arthroplasty (RTSA) increases deltoid tension, which could potentially lead to excessive stress on a pre-existent os acromiale. The purpose of this study was to determine the outcome and complications of primary RTSA in patients with radiographic evidence of an os acromiale. METHODS: Between 2005 and 2013, 25 shoulders underwent primary RTSA with an associated os acromiale, which was classified preacromion (3), mesoacromion (20), and meta-acromion (2)...
May 5, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28479257/liposomal-bupivacaine-versus-indwelling-interscalene-nerve-block-for-postoperative-pain-control-in-shoulder-arthroplasty-a-prospective-randomized-controlled-trial
#18
Jeffrey T Abildgaard, Keith T Lonergan, Stefan J Tolan, Michael J Kissenberth, Richard J Hawkins, Richard Washburn, Kyle J Adams, Catherine D Long, E Carlisle Shealy, Jay R Motley, John M Tokish
BACKGROUND: Pain management strategies following shoulder arthroplasty vary significantly. Liposomal bupivacaine (LB) is an extended-release delivery of a phospholipid bilayer encapsulating bupivacaine that can result in drug delivery up to 72 hours. Prior studies in lower extremity surgery demonstrated efficacy of LB in comparison to a single-shot peripheral nerve block; however, no study has investigated LB in a total shoulder arthroplasty population. Therefore, this study compared LB vs...
May 4, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28478900/the-effect-of-the-beach-chair-position-angle-on-cerebral-oxygenation-during-shoulder-surgery
#19
Chad E Songy, Eric R Siegel, Mark Stevens, John T Wilkinson, Shahryar Ahmadi
BACKGROUND: Although the safety of the beach-chair position (BCP) is widely accepted, rare devastating neurologic complications have been reported and attributed to cerebral hypoperfusion. Cerebral oxygenation (regional oxygen saturation [rSO2]) can be monitored noninvasively using near-infrared spectroscopy. The purpose of this study was to determine the effect of BCP angle on cerebral oxygenation in patients undergoing shoulder surgery in the BCP. METHODS: Fifty patients undergoing shoulder arthroscopy were prospectively enrolled to participate...
May 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28467335/fifth-metacarpal-neck-fractures-fixation-with-antegrade-locked-flexible-intramedullary-nailing
#20
Francesco Pogliacomi, Elisabetta Mijno, Alesssio Pedrazzini, Silvio Tocco, Massimo Tonani, Francesco Ceccarelli, Enrico Vaienti
BACKGROUND: Fifth metacarpal neck fractures (commonly named "boxer's fractures") are the most common metacarpal injuries and usually affect young active people. These lesions are mainly treated conservatively. Their surgical management, if indicated, is still a matter of debate. Different procedures have been described. The aim of this study was to evaluate the outcomes of 18 boxer's fractures which were synthesized with antegrade locked flexible intramedullary nailing. MATERIALS AND METHODS: All patients, at a mean follow-up of 45 months, were clinically evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Patient Rated Wrist/Hand Evaluation (PRWHE)...
April 28, 2017: Acta Bio-medica: Atenei Parmensis
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