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https://www.readbyqxmd.com/read/28735841/the-perioperative-effects-of-chronic-preoperative-opioid-use-on-shoulder-arthroplasty-outcomes
#1
Jonathan W Cheah, David C Sing, Dell McLaughlin, Brian T Feeley, C Benjamin Ma, Alan L Zhang
HYPOTHESIS AND BACKGROUND: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. METHODS: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28732072/placental-peptides-metabolism-and-maternal-factors-as-predictors-of-risk-of-gestational-diabetes-in-pregnant-women-a-case-control-study
#2
Robert Amadu Ngala, Linda Ahenkorah Fondjo, Peter Gmagna, Frank Naku Ghartey, Martin Akilla Awe
BACKGROUND: Gestational diabetes is a risk factor for perinatal complications; include shoulder dystocia, birth injuries such as bone fractures and nerve palsies. It is associated with later development of type 2 diabetes, the risk of macrosomia and other long-term health effects of infants born to diabetic mothers. The study assesses placental peptides and maternal factors as potential predictors of gestational diabetes among pregnant women. MATERIAL AND METHODS: A total of 200 pregnant women were recruited for the study, 150 pregnant women without pre gestational diabetes including 50 women with low risk factors of diabetes as controls and 50 other pregnant women with pregestational diabetes as control...
2017: PloS One
https://www.readbyqxmd.com/read/28719990/radiographic-and-clinical-assessment-of-intramedullary-nail-fixation-for-the-treatment-of-unstable-metacarpal-fractures
#3
Ather Mirza, Justin Mirza, Chris Healy, Vishaaq Mathew, Brian Lee
BACKGROUND: The purpose of the article was to evaluate clinical and radiographic outcomes in a case series of unstable metacarpal fractures treated with flexible intramedullary nail (IMN) fixation. METHODS: A total of 55 patients with unstable metacarpal fractures between 2003 and 2010 were treated with IMN fixation and followed for a minimum of 1 year. The outcomes were assessed via a radiological study of longitudinal and angular collapse, Disabilities of the Arm, Shoulder, and Hand (DASH) score, total active range of motion (ROM) of the wrist, and grip strength testing...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28711169/the-risk-of-suprascapular-and-axillary-nerve-injury-in-reverse-total-shoulder-arthroplasty-an-anatomic-study
#4
Tim Leschinger, Michael Hackl, Eduard Buess, Sebastian Lappen, Martin Scaal, Lars Peter Müller, Kilian Wegmann
PURPOSE: Implantation of a reverse total shoulder arthroplasty (rTSA) places the axillary and suprascapular nerves at risk. The aim of this anatomic study was to digitally analyse the location of these nerves in relation to bony landmarks in order to predict their path and thereby help to reduce the risk of neurological complications during the procedure. METHODS: A total of 22 human cadaveric shoulder specimens were used in this study. The axillary and suprascapular nerves were dissected, and radiopaque threads were sutured onto the nerves without mobilizing the nerves from their native paths...
June 28, 2017: Injury
https://www.readbyqxmd.com/read/28710344/position-of-immobilization-after-first-time-traumatic-anterior-glenohumeral-dislocation-a-literature-review
#5
Olga Gutkowska, Jacek Martynkiewicz, Jerzy Gosk
Anterior glenohumeral dislocation affects about 2% of the general population during the lifetime. The incidence of traumatic glenohumeral dislocation ranges from 8.2 to 26.69 per 100 000 population per year. The most common complication is recurrent dislocation occurring in 17-96% of the patients. The majority of patients are treated conservatively by closed reduction and immobilization in internal rotation for 2-3 weeks. However, no clear conservative treatment protocol exists. Immobilization in external rotation can be considered an alternative...
July 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28702700/clinical-and-radiological-outcomes-after-reverse-shoulder-arthroplasty-with-less-medialized-endoprosthesis-after-mean-follow-up-time-of-45%C3%A2-months
#6
Justinas Jonušas, Rūta Banytė, Sigitas Ryliškis
INTRODUCTION: The purpose of this study was to evaluate outcomes after reverse shoulder arthroplasty for the treatment of complex three- and four-fragment proximal humeral fractures after mean follow-up time of 45 months and to compare our results with the results published by other authors. MATERIALS AND METHODS: Retrospectively we have analyzed 27 consecutive patients after total arthroplasty with less medialized reverse shoulder prosthesis used for the treatment of complex proximal humeral fracture...
July 12, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28699404/improved-external-rotation-with-concomitant-reverse-total-shoulder-arthroplasty-and-latissimus-dorsi-tendon-transfer-a-systematic-review
#7
Aaron Wey, John C Dunn, Nicholas Kusnezov, Brian R Waterman, Kelly G Kilcoyne
BACKGROUND: In conjunction with reverse total shoulder arthroplasty (RSA), latissimus dorsi and teres major (LD-TM) transfer has been advocated in the setting of combined loss of elevation and external rotation. The purpose of this systematic review is to summarize the clinical outcomes following RSA with LD-TM transfer. METHODS: A search of PubMed, EMBASE, CINAHL, Medline, and Cochrane databases was performed between January 1, 1990 and March 1, 2016 and included articles related to outcomes following RSA with LD-TM transfer...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28699149/is-the-clavicula-pro-humero-technique-of-value-for-reconstruction-after-resection-of-the-proximal-humerus-in-children
#8
Dominique Barbier, Benoît De Billy, Philippe Gicquel, Sophie Bourelle, Pierre Journeau
BACKGROUND: There are several options for reconstruction of proximal humerus resections after wide resection for malignant tumors in children. The clavicula pro humero technique is a biologic option that has been used in the past, but there are only scant case reports and small series that comment on the results of the procedure. Because the longevity of children mandates a reconstruction with potential longevity not likely to be achieved by other techniques, the clavicula pro humero technique may be a potential option in selected patients...
July 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28699147/what-are-the-complications-survival-and-outcomes-after-revision-to-reverse-shoulder-arthroplasty-in-patients-older-than-80-years
#9
Eduard Alentorn-Geli, Nicholas J Clark, Andrew T Assenmacher, Brian T Samuelsen, Joaquín Sánchez-Sotelo, Robert H Cofield, John W Sperling
BACKGROUND: By the time patients with a failed shoulder arthroplasty require revision surgery, a substantial number are older than 80 years. The risk of complications of revision arthroplasty in this elderly population is largely unknown and needs to be considered when contemplating whether these patients are too frail for revision surgery. QUESTIONS/PURPOSES: (1) What are the 90-day medical and surgical complications after revision to reverse shoulder arthroplasty (RSA) in patients older than 80 years? (2) What are the 2- and 5-year survival rates after revision? (3) Was there an improvement in pain at rest or with activity, range of motion (ROM), and strength after revision surgery? METHODS: Between 2004 and 2013, 38 patients who were older than 80 years (84 ± 3 years) underwent revision surgery to a RSA...
July 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28690459/functional-outcomes-of-modular-conversion-of-hemiarthroplasty-or-total-to-reverse-total-shoulder-arthroplasty
#10
Phillip N Williams, Samir K Trehan, Nicholas Tsouris, Joshua S Dines, David M Dines, Edward V Craig, Lawrence V Gulotta, Russell F Warren
BACKGROUND: The advent of modular shoulder arthroplasty systems has allowed the conversion of hemiarthroplasty or total shoulder arthroplasty to reverse total shoulder arthroplasty (RTSA) without removing a well-fixed stem. QUESTIONS/PURPOSES: To determine the feasibility, functional outcome, and complication profile of RTSA modular conversion. METHODS: A prospective shoulder arthroplasty registry was queried for consecutive patients scheduled for a modular conversion from January 1, 2007, to April 1, 2015...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28689929/serum-c-reactive-protein-in-patients-undergoing-elective-shoulder-arthroplasty-prospective-study
#11
Carlos Torrens, Fernando Santana, Raquel Marí, Lluis Puig, Albert Alier
BACKGROUND: The objective of the study was to determine the normalization curve of the serum C-reactive protein (CRP) in elective shoulder arthroplasty. METHODS: A prospective study including 58 consecutive patients who had undergone elective shoulder arthroplasty. Forty-one patients had received a Reverse Shoulder Arthroplasty, 13 a Total Shoulder Arthroplasty and 4 a Hemiarthroplasty. Based on a pilot study, blood samples to determine CRP values were obtained at baseline (1 h before surgery), on the 1st, 2nd, 6th, 8th and 14th postoperative days...
July 7, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28689829/polyethylene-dissociation-from-humeral-stem-status-after-reverse-total-shoulder-arthroplasty
#12
Karan A Patel, Kara L Boyd, Kevin J Renfree, Steven J Hattrup
BACKGROUND: Reverse shoulder arthroplasty (RSA) is an important treatment option for 4-part proximal humerus fractures in the elderly and arthrosis of the glenohumeral joint with incompetence of the rotator cuff. Unique complications do occur with use of this type of prosthesis. METHODS: We present 4 cases of polyethylene dissociation after RSA. RESULTS: In a series of 549 patients who underwent RSA, the incidence of polyethylene dissociation was found to be 0...
July 6, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28687191/single-anterior-portal-a-better-option-for-arthroscopic-treatment-of-traumatic-anterior-shoulder-instability
#13
Hakan Çiçek, Ümit Tuhanioğlu, Hasan Ulaş Oğur, Fırat Seyfettinoğlu, Osman Çiloğlu, Tahsin Beyzadeoğlu
OBJECTIVE: The aim of this study was to compare single and double anterior portal techniques in the arthroscopic treatment of traumatic anterior shoulder instability. METHODS: A total of 91 cases who underwent arthroscopic Bankart repair for anterior shoulder instability were reviewed. The patients were divided into 2 groups as Group 1 (47 male and 2 female; mean age: 25.8 ± 6.8) for arthroscopic single anterior portal approach and Group 2 (41 male and 1 female; mean age: 25...
July 4, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28669466/editorial-commentary-volume-and-outcome-100%C3%A2-years-of-perspective-on-value-from-e-a-codman-to-m-e-porter
#14
EDITORIAL
Jon J P Warner, Laurence D Higgins
Outcome is the numerator for the value equation, with the denominator being cost; measurement of each is essential to determine the most effective care. With regard to both total shoulder arthroplasty and rotator cuff repair, outcomes of low (vs high) volume providers are associated with longer hospital stay, longer length of operating room time, increased hospital complications, and cost. This suggests that volume thresholds are a key to providing greater value. However, this effect can be modified through systematic efforts to measure outcome and thus improve...
July 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28668181/arthroscopic-joint-preservation-in-severe-glenohumeral-arthritis-using-interpositional-human-dermal-allograft
#15
Robert U Hartzler, Sabelo Melapi, Joe F de Beer, Stephen S Burkhart
PURPOSE: To investigate the outcomes of arthroscopic glenoid resurfacing (AGR) for severe glenohumeral arthritis at short- to medium-term follow-up. METHODS: We performed a multicenter retrospective review of consecutive patients undergoing AGR (2005-2013) with a minimum of 2 years' follow-up or until revision. Patients lost to follow-up and those included in a prior study were excluded. The indications for AGR were severe primary shoulder osteoarthritis without significant bone loss in younger, higher-demand patients...
June 28, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28663405/prospective-randomised-trial-of-non-operative-versus-operative-management-of-olecranon-fractures-in-the-elderly
#16
A D Duckworth, N D Clement, J E McEachan, T O White, C M Court-Brown, M M McQueen
AIMS: The aim of this prospective randomised controlled trial was to compare non-operative and operative management for acute isolated displaced fractures of the olecranon in patients aged ≥ 75 years. PATIENTS AND METHODS: Patients were randomised to either non-operative management or operative management with either tension-band wiring or fixation with a plate. They were reviewed at six weeks, three and six months and one year after the injury. The primary outcome measure was the Disabilities of the Arm, Shoulder and Hand (DASH) score at one year...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28663400/comparative-outcomes-of-outpatient-and-inpatient-total-shoulder-arthroplasty-an-analysis-of-the-medicare-dataset
#17
B A Basques, B J Erickson, T Leroux, J W Griffin, R M Frank, N N Verma, A A Romeo
AIMS: The aim of the present study was to compare the 30- and 90-day re-admission rates and complication rates of outpatient and inpatient total shoulder arthroplasty (TSA). PATIENTS AND METHODS: The United States Medicare Standard Analytical Files database was questioned to identify patients who had undergone outpatient or inpatient TSA between 2005 and 2012. Patient characteristics were compared between the two groups using chi-squared analysis. Multivariate logistic regression analysis was used to control for differences in baseline patient characteristics and to compare the two groups in terms of post-operative complications within 90 days and re-admission within 30 days and 90 days...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28659057/anatomical-shoulder-arthroplasty-in-epileptic-patients-with-instability-arthropathy-and-persistent-seizures
#18
Tanujan Thangarajah, Mark Falworth, Simon M Lambert
PURPOSE: Epileptic seizures can cause shoulder dislocation, recurrent instability and eventually arthritis. The purpose of this study was to report the results, complications and rate of revision surgery following anatomical shoulder arthroplasty in epileptic patients with instability arthropathy. METHODS: A consecutive series of eight patients with epilepsy underwent anatomical shoulder arthroplasty for recurrent shoulder instability and were retrospectively reviewed after a mean of 4...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28646420/composite-reverse-shoulder-arthroplasty-can-provide-good-function-and-quality-of-life-in-cases-of-malignant-tumour-of-the-proximal-humerus
#19
Cyril Lazerges, Louis Dagneaux, Benjamin Degeorge, Nicolas Tardy, Bertrand Coulet, Michel Chammas
PURPOSE: Management of proximal humeral tumours remains a surgical challenge. No study to date has assessed the quality of life scores following the composite reverse shoulder arthroplasty for this indication. We, therefore, evaluated function and quality of life following reconstruction with allograft for malignant tumour of the humerus. METHODS: A series of six cases of humeral tumour treated by a single surgeon in a single centre was reviewed after a mean follow-up of 5...
June 23, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28644943/failure-of-wrist-hemiarthroplasty
#20
Eric G Huish, Zachary Lum, H Brent Bamberger, Marc A Trzeciak
BACKGROUND: Wrist hemiarthroplasty has emerged as a motion-sparing option for severe wrist arthritis. It is technically easy with advantages of limited bone resection and no risk of nonunion. Given the relative infancy of the procedure in clinical practice, there are limited data on patient outcomes. METHODS: Eleven patients were treated with wrist reconstructive hemiarthroplasty. Indications included 1 patient with scaphoid nonunion advanced collapse, 9 patients with scapholunate advanced collapse, and 1 patient with capitolunate arthritis...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
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