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Reverse total shoulder arthroplasty

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https://www.readbyqxmd.com/read/29661111/anatomic-total-shoulder-arthroplasty-with-posterior-capsular-plication-versus-reverse-shoulder-arthroplasty-in-patients-with-biconcave-glenoids-a-matched-cohort-study
#1
Eduard Alentorn-Geli, Nathan R Wanderman, Andrew T Assenmacher, John W Sperling, Robert H Cofield, Joaquín Sánchez-Sotelo
PURPOSE: To compare the outcomes of total shoulder arthroplasty (TSA) with posterior capsule plication (PCP) and reverse shoulder arthroplasty (RSA) in patients with primary osteoarthritis, posterior subluxation, and bone loss (Walch B2). PATIENTS AND METHODS: All shoulders undergoing anatomic TSA with PCP were retrospectively identified (group 1, G1) and compared to shoulders undergoing RSA (group 2, G2) for Walch B2 osteoarthritis. There were 15 patients in G1 (mean (SD) age and follow-up of 70...
May 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29658976/current-trends-in-the-use-of-shoulder-arthroplasty-in-the-united-states
#2
John A Palsis, Kit N Simpson, J Hunter Matthews, Sophia Traven, Josef K Eichinger, Richard J Friedman
Reverse total shoulder arthroplasty (rTSA) has become increasingly popular since its introduction to the United States. The purpose of this study was to assess the current trends and use of rTSA, anatomic total shoulder arthroplasty (aTSA), and hemiarthroplasty (HA) from 2011 to 2014. Shoulder arthroplasty data from the National (Nationwide) Inpatient Sample database were analyzed for the years 2011 to 2014 using International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes...
April 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29657846/reverse-total-shoulder-arthroplasty
#3
Filippo Familiari, Jorge Rojas, Mahmut Nedim Doral, Gazi Huri, Edward G McFarland
Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased.Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff.RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching...
February 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29628689/going-forward-with-reverse-shoulder-arthroplasty
#4
REVIEW
Keshav Singhal, Rammohan R
Rotator cuff is a vital structure of glenohumeral joint, the dysfunction of which leads to debilitating pain and restricted movement. Arthroplasty using unconstrained anatomical prosthesis for treating these conditions have not been successful in the past. Reverse Shoulder Arthroplasty (RSA) is a novel technique specifically designed to address end stage glenohumeral arthritis in rotator cuff deficient joint. Short and mid-term studies have demonstrated a significant improvement in pain and range of motion of the shoulder joint...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29611851/managing-glenoid-bone-deficiency-the-augment-experience-in-anatomic-and-reverse-shoulder-arthroplasty
#5
Rowan J Michael, Bradley S Schoch, Joseph J King, Thomas W Wright
Glenoid bone deficiency in the setting of shoulder replacement surgery is far more common than originally reported. The frequency and severity of the glenoid defects are noted to be more common and severe with the advent of computer-assisted surgery. The results of an anatomic total shoulder arthroplasty (aTSA) with glenoid deficiency have been reported to be inferior to aTSA patients without a glenoid deficiency. Options for treating the glenoid deficiency include eccentric reaming, bone grafting, and the use of augmented glenoid components...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29605518/shoulder-arthroplasty-for-sequelae-of-obstetrical-brachial-plexus-injury
#6
Jean-David Werthel, Bradley Schoch, Mark Frankle, Robert Cofield, Bassem T Elhassan
PURPOSE: Shoulder arthroplasty following obstetrical brachial plexus injury (OBPI) is technically challenging because glenoid morphology, muscle balance, and humeral version are substantially altered compared with the neurologically intact shoulder. The purpose of this study is to report the outcome of shoulder arthroplasty in a group of patients with end-stage arthritis secondary to OBPI. MATERIALS AND METHODS: Seven patients with OBPI and secondary glenohumeral arthritis were treated with shoulder arthroplasty between 1976 and 2014...
March 29, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29601384/are-age-and-patient-gender-associated-with-different-rates-and-magnitudes-of-clinical-improvement-after-reverse-shoulder-arthroplasty
#7
Richard J Friedman, Emilie V Cheung, Pierre-Henri Flurin, Thomas Wright, Ryan W Simovitch, Charlotte Bolch, Christopher P Roche, Joseph D Zuckerman
BACKGROUND: An improved understanding of how gender differences and the natural aging process are associated with differences in clinical improvement in outcome metric scores and ROM measurements after reverse total shoulder arthroplasty (rTSA) may help physicians establish more accurate patient expectations for reducing postoperative pain and improving function. QUESTIONS/PURPOSES: (1) Is gender associated with differences in rTSA outcome scores like the Simple Shoulder Test (SST), the UCLA Shoulder score, the American Shoulder and Elbow Surgeons (ASES) Shoulder score, the Constant Shoulder score, and the Shoulder Pain and Disability Index (SPADI) and ROM? (2) Is age associated with differences in rTSA outcome scores and ROM? (3) What factors are associated with the combined interaction effect between age and gender? (4) At what time point during recovery does most clinical improvement occur, and when is full improvement reached? METHODS: We quantified and analyzed the outcomes of 660 patients (424 women and 236 men; average age, 72 ± 8 years; range, 43-95 years) with cuff tear arthropathy or osteoarthritis and rotator cuff tear who were treated with rTSA by 13 shoulder surgeons from a longitudinally maintained international database using a linear mixed effects statistical model to evaluate the relationship between clinical improvements and gender and patient age...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29589495/reverse-shoulder-arthroplasty-for-type-1-sequelae-of-a-fracture-of-the-proximal-humerus
#8
MULTICENTER STUDY
P Raiss, G Alami, T Bruckner, P Magosch, P Habermeyer, P Boileau, G Walch
Aims The aim of this study was to analyze the results of reverse shoulder arthroplasty (RSA) in patients with type 1 sequelae of a fracture of the proximal humerus in association with rotator cuff deficiency or severe stiffness of the shoulder. Patients and Methods A total of 38 patients were included: 28 women and ten men. Their mean age at the time of arthroplasty was 73 years (54 to 91). Before the RSA, 18 patients had been treated with open reduction and internal fixation following a fracture. A total of 22 patients had a rotator cuff tear and 11 had severe stiffness of the shoulder with < 0° of external rotation...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29582118/reverse-total-shoulder-arthroplasty-using-helical-blade-to-optimize-glenoid-fixation-and-bone-preservation-preliminary-results-in-thirty-five-patients-with-minimum-two-year-follow-up
#9
Sebastien Zilber, Eleonora Camana, Peter Lapner, Emil Haritinian, Laurent Nove Josserand
PURPOSE: Glenoid loosening is a common cause of reverse total shoulder arthroplasty (RTSA) failure, and grafting of the glenoid is often required for revision due to bone loss due to the central peg in most glenoid baseplates. Helical blades have been used in the hip to optimize bone fixation in proximal femoral fracture. This study presents the initial results of specifically designed helical blade in the shoulder to optimize glenoid bone fixation and preservation as part of RTSA. METHODS: Thirty-five patients underwent RTSA with glenoid helical blade fixation...
March 26, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29572639/can-patients-manage-toileting-after-reverse-total-shoulder-arthroplasty-a-systematic-review
#10
REVIEW
Jorge Rojas, Jacob Joseph, Bingli Liu, Uma Srikumaran, Edward G McFarland
PURPOSE: A major concern for patients undergoing reverse total shoulder arthroplasty (RTSA) is managing toileting after surgery. The goals of this systematic review of RTSA studies were to determine the following: (1) the percentage of patients who can manage toileting, (2) their degree of difficulty with toileting, and (3) the percentage of patients who can manage toileting after bilateral versus unilateral RTSA. METHODS: Medline, EMBASE, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched for studies reporting the ability to manage toileting after RTSA...
March 23, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29552690/outcomes-of-shoulder-arthroplasty-in-diabetic-patients-as-assessed-by-peri-operative-a1c
#11
Joseph M Statz, Eric R Wagner, John W Sperling, Robert H Cofield
PURPOSE: Although diabetes mellitus (DM) has an adverse effect on complication rates in orthopaedic surgery, neither the effect of DM nor the association between haemoglobin A1C (HbA1C) and outcomes after shoulder arthroplasty (SA) has been studied. METHODS: A retrospective review of 406 SAs (70 HAs, 188 total shoulder arthroplasties [TSAs], 148 reverse total shoulder arthroplasties [RSAs]) with HbA1Cs within 90 days of surgery was conducted. The average age was 70 years (range 27-97) and 55% were female...
March 18, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29548544/effects-of-cemented-versus-press-fit-primary-humeral-stem-fixation-in-the-setting-of-revision-shoulder-arthroplasty
#12
Madeleine A Salesky, Trevor R Grace, Brian T Feeley, C Benjamin Ma, Alan L Zhang
BACKGROUND: The influence of primary humeral stem fixation method (cemented or press fit) on intraoperative or postoperative outcomes in the setting of revision shoulder arthroplasty is unknown. METHODS: A retrospective analysis of a prospectively collected cohort of revision shoulder arthroplasty patients from a single tertiary center was performed. Demographic variables, intraoperative data, and 90-day complication rates were compared between cemented and press-fit primary stem fixation cohorts...
March 13, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29535876/ultrasound-guided-interscalene-catheter-complicated-by-persistent-phrenic-nerve-palsy
#13
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
https://www.readbyqxmd.com/read/29516107/-reversed-total-shoulder-arthroplasty-in-rotator-cuff-defect-arthropathy
#14
REVIEW
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
https://www.readbyqxmd.com/read/29515680/transosseous-suture-fixation-of-true-4-part-valgus-impacted-fractures-of-the-proximal-humerus-clinical-and-radiological-outcome-in-49-patients
#15
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
https://www.readbyqxmd.com/read/29511786/-anatomical-total-shoulder-replacement-in-glenohumeral-osteoarthritis-indications-current-implants-and-clinical-results
#16
REVIEW
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
https://www.readbyqxmd.com/read/29494745/functional-outcomes-and-predictors-of-failure-after-rotator-cuff-repair-during-total-shoulder-arthroplasty
#17
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
https://www.readbyqxmd.com/read/29494718/patient-specific-guides-instrumentation-in-shoulder-arthroplasty
#18
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
https://www.readbyqxmd.com/read/29494717/convertible-glenoid-components-facilitate-revisions-to-reverse-shoulder-arthroplasty-easier-retrospective-review-of-13-cases
#19
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
https://www.readbyqxmd.com/read/29473831/understanding-the-importance-of-the-teres-minor-for-shoulder-function-functional-anatomy-and-pathology
#20
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
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