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Reverse total shoulder arthroplasty

Ryan Nelson, Jeremiah T Lowe, Sarah M Lawler, Megan Fitzgerald, Matthew T Mantell, Andrew Jawa
Heterotopic ossification and scapular notching are common following reverse total shoulder arthroplasty. Compared with the original Grammont-style prosthesis with a medialized center of rotation (COR) and a 155° neck-shaft angle, lateralization of COR and reduction of neck-shaft angle have been associated with decreased incidence of scapular notching. The authors hypothesized that these design features may also be effective in reducing heterotopic ossification after reverse total shoulder arthroplasty. Ninety-seven consecutive patients who underwent reverse total shoulder arthroplasty performed by a single surgeon were included in the study...
June 18, 2018: Orthopedics
Edward G McFarland
No abstract text is available yet for this article.
June 13, 2018: Clinical Orthopaedics and related Research
Thema Nicholson, Mitchell Maltenfort, Charles Getz, Mark Lazarus, Gerald Williams, Surena Namdari
Background: Our institution's traditional pain management strategy after shoulder arthroplasty has involved the utilization of postoperative patient-controlled narcotic analgesia. More recently, we have implemented a protocol (TLC) that utilizes a multimodal approach. The purpose of this study was to determine whether this change has improved pain control and decreased narcotic utilization. Methods: Patients undergoing primary total shoulder or reverse arthroplasty were retrospectively studied...
May 2018: Archives of Bone and Joint Surgery
Jennifer Kurowicki, Samuel Rosas, Tsun Yee Law, Johnathan C Levy
Both anatomical total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) are routinely performed for patients who desire to continuously work or participate in sports. This study analyzes and compares the ability of patients to work and partake in sports following shoulder arthroplasty based on responses to clinical outcome surveys. A retrospective review of the shoulder surgery repository was performed for all patients treated with TSA and RSA and who completed questions 9 and 10 on the activity patient self-evaluation portion of the American Shoulder and Elbow Surgeons (ASES) Assessment Form...
May 2018: American Journal of Orthopedics
Jonas Pogorzelski, Marilee P Horan, Jonathan A Godin, Zaamin B Hussain, Erik M Fritz, Peter J Millett
INTRODUCTION: The purpose of this study was to investigate clinical outcomes following Achilles tendon allograft-augmented latissimus dorsi tendon transfer (LDTT) for the treatment of irreparable posterosuperior rotator cuff tears with a minimum of 2 years post-operative follow-up. We hypothesized that patients would show significant improvement in outcomes scores with a low failure rate. MATERIALS AND METHODS: Patients who were treated with Achilles tendon allograft-augmented LDTT for irreparable posterosuperior rotator cuff tears with a minimum follow-up of 2 years were included...
June 6, 2018: Archives of Orthopaedic and Trauma Surgery
E M Guerrero, M P Morwood, R A Kankaria, P S Johnston, G E Garrigues
PURPOSE: To determine whether lesser tuberosity osteotomy (LTO) and mini-stem humeral components (MSHCs) can be safely and effectively used together in total and hemi-shoulder arthroplasty (TSA/HHA). METHODS: This is a retrospective review of consecutive patients who underwent anatomic TSA/HHA utilizing combined LTO/MSHC with minimum 2-year follow-up. Six-week and final radiographs, range of motion, pain scores, and selected outcome measures were assessed. RESULTS: Seventy five shoulders with mean follow-up of 27...
June 1, 2018: Musculoskeletal Surgery
Keith M Baumgarten, Peter S Chang, Tasha M Dannenbring, Elaine K Foley
BACKGROUND: Total shoulder arthroplasty (TSA) decreases pain, improves range of motion, and increases strength. Whether these improvements translate to improvements in activity levels postoperatively remains unknown. The Shoulder Activity Level (SAL) is a valid and reliable outcomes survey that measures the patient's activity level. Currently, no studies have specifically examined the effect of TSA on SAL. METHODS: A prospective collection of preoperative, patient-determined outcomes on patients undergoing TSA was compared with postoperative scores at a minimum of 2 years...
May 24, 2018: Journal of Shoulder and Elbow Surgery
Stephen S Burkhart
Active patients with massive irreparable rotator cuff tears and no glenohumeral arthritis have long posed a dilemma for shoulder surgeons. Such high-demand patients do not do well with partial cuff repair, as their results tend to deteriorate over time. They are also not good candidates for reverse total shoulder arthroplasty due to high rates of complications and high revision rates. The early good results of superior capsular reconstruction for these challenging patients are very encouraging, and they highlight the potential for superior capsular reconstruction to be a reliable joint-preserving option with low morbidity...
June 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Chang-Yeon Kim, Lakshmanan Sivasundaram, Mark W LaBelle, Nikunj N Trivedi, Raymond W Liu, Robert J Gillespie
BACKGROUND: Rising health care expenditures and the adoption of bundled-care initiatives require efficient resource allocation for shoulder arthroplasty. To determine a reliable and accessible metric for implementing perioperative care pathways, we compared the accuracy of the Elixhauser Comorbidity Measure (ECM) and Charlson Comorbidity Index (CCI) for predicting adverse events and postoperative discharge destination after shoulder arthroplasty. MATERIALS AND METHODS: The National Inpatient Sample was queried for patients who underwent total shoulder arthroplasty or reverse total shoulder arthroplasty between 2002 and 2014...
May 21, 2018: Journal of Shoulder and Elbow Surgery
Stephanie E Wong, Alexis K Colley, Austin A Pitcher, Alan L Zhang, C Benjamin Ma, Brian T Feeley
BACKGROUND: Mental health conditions are associated with poor outcomes in patients with chronic disease as well as various orthopedic conditions. The purpose of this study was to describe the relationship between mental health, preoperative disability, and postoperative outcomes in patients undergoing shoulder arthroplasty. METHODS: Data, including mental health diagnoses, were prospectively collected from patients undergoing total shoulder arthroplasty or reverse total shoulder arthroplasty from 2009 to 2015 at a single academic institution...
May 21, 2018: Journal of Shoulder and Elbow Surgery
Jason Chui, John M Murkin, Darren Drosdowech
INTRODUCTION: Peripheral nerve injury is a potentially devastating complication after total shoulder arthroplasty (TSA) surgery. This pilot study aimed to assess the feasibility of using an automated somatosensory evoked potential (SSEP) device to provide a timely alert/intervention to minimize intraoperative nerve insults during TSA surgery. METHODS: A prospective, single-arm, observational study was conducted in a single university hospital. The attending anesthesiologist monitored the study participants using the EPAD automated SSEP device and an intervention was made if there was an alert during TSA surgery...
May 21, 2018: Journal of Neurosurgical Anesthesiology
Robert Z Tashjian, Brook I Martin, Cassandra A Ricketts, Heath B Henninger, Erin K Granger, Peter N Chalmers
BACKGROUND: Instability is the most common complication after reverse total shoulder arthroplasty (rTSA). In the native glenohumeral joint, in addition to full dislocations, more subtle forms of instability exist. However, the incidence of more subtle forms of instability, the factors associated with instability, and the effect of instability on validated outcome scores after rTSA remain poorly understood. QUESTIONS/PURPOSES: (1) After rTSA, what is the risk of instability, including more subtle forms of subjective instability? (2) What are the factors associated with instability? (3) Are more subtle forms of instability associated with lower American Shoulder and Elbow Surgeons (ASES) functional outcome scores than those patients without instability? METHODS: A total of 168 rTSAs were performed during the study period...
May 17, 2018: Clinical Orthopaedics and related Research
Dominik Knierzinger, Christian H Heinrichs, Clemens Hengg, Marko Konschake, Franz Kralinger, Werner Schmoelz
BACKGROUND: Sufficient tuberosity fixation in proximal humeral fractures treated with shoulder arthroplasty is essential to gain a good clinical outcome. This biomechanical study evaluated the strength of the reattached tuberosities in reverse total shoulder arthroplasty fixed with cables or with sutures in a cerclage-like technique. Considering the mechanical advantages of flexible titanium alloy cables compared with conventional sutures for cerclage-like fixations, we hypothesized that titanium alloy cables would achieve higher fixation strengths of the tuberosities compared with heavy nonabsorbable sutures...
May 17, 2018: Journal of Shoulder and Elbow Surgery
David D Savin, Rachel M Frank, Shelby Sumner, Catherine Richardson, Gregory P Nicholson, Anthony A Romeo
BACKGROUND: This study evaluated how body mass index (BMI) factors into functional outcomes and complications after shoulder arthroplasty. METHODS: A retrospective analysis was performed of age-matched patients with a minimum 2-year follow-up after total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), or hemiarthroplasty (HA). Patient-reported outcome (PRO) scores, range of motion (ROM), and complications were assessed. Forty-nine patients were classified into the following groups: normal (BMI <24...
June 2018: Journal of Shoulder and Elbow Surgery
Jeremy S Somerson, Jason E Hsu, Moni B Neradilek, Frederick A Matsen
BACKGROUND: Most of the literature on shoulder arthroplasty failure comes from high-volume centers. These reports tend to exclude the experience of community orthopedic surgeons, who perform most of the shoulder joint replacements. METHODS: We analyzed the failure reports mandated by the US Food and Drug Administration for all hospitals. Each reported event from 2012 to 2016 was characterized by implant, failure mode, and year of surgery. RESULTS: For the 1673 anatomic arthroplasties, the most common failure modes were glenoid component failure (20...
May 11, 2018: Journal of Shoulder and Elbow Surgery
Mihir M Sheth, Daniel Sholder, Joseph Abboud, Mark D Lazarus, Matthew L Ramsey, Gerald R Williams, Surena Namdari
BACKGROUND: The impending burden of revision shoulder arthroplasty has increased interest in outcomes of revision procedures. Painful glenoid arthrosis following hemiarthroplasty is a common cause of reoperation, and conversion to anatomic total shoulder arthroplasty is one option. METHODS: We identified patients who underwent revision of painful hemiarthroplasty to total shoulder arthroplasty over a 15-year period in a single tertiary-care health system. Presurgical and operative data were analyzed for 28 patients who met the inclusion and exclusion criteria...
May 10, 2018: Journal of Shoulder and Elbow Surgery
Giovanni Merolla, Simone Cerciello, Stefano Marenco, Elisabetta Fabbri, Paolo Paladini, Giuseppe Porcellini
PURPOSE: We hypothesized that osteoarthritis developing after instability surgery is radiographically similar to primary arthritis and that arthroplasty provides comparable outcomes in patients with these two types of osteoarthritis. METHODS: Patients with osteoarthritis due to instability surgery (group I) and with primary osteoarthritis (group II) were included. Mean follow-up was 52.6 and 41.6 months, respectively. Hemiarthroplasties (HA) were 32% in group I and 27% in group II; total shoulder arthroplasties (TSA) were 68 and 73% respectively...
May 12, 2018: International Orthopaedics
Jeremy S Somerson, Jason E Hsu, Moni B Neradilek, Frederick A Matsen
BACKGROUND: A patient with arthritis usually experiences the progression of symptoms over time. At some stage, the patient may decide that the symptoms have reached a level of severity that leads him or her to elect to proceed with joint replacement; we refer to this degree of symptom severity as the "tipping point." Our goal was to study the factors that influenced the tipping point for patients undergoing elective shoulder arthroplasty. METHODS: We analyzed the characteristics of 931 patients undergoing shoulder arthroplasty to determine the factors affecting the tipping point as characterized by the patients' comfort and function at the time they determined their symptoms had progressed to the point when this elective surgery was merited...
May 7, 2018: Journal of Shoulder and Elbow Surgery
Eric R Wagner, Muriel J Solberg, Laurence D Higgins
Study Design Epidemiological retrospective database study. Background It is widely believed that structured rehabilitation programs by professional therapists help guide patients through the various recovery periods after shoulder arthroplasty, speeding up their recovery and improving their final functional gains. However, to our knowledge, there are no studies providing information about the current state of physical rehabilitation use after shoulder arthroplasty. Objectives Describe the variation in physical rehabilitation utilization after total and reverse total shoulder arthroplasty and identify differences in utilization based on type of insurance (private versus public), gender, age, region of the country, and type of replacement...
May 8, 2018: Journal of Orthopaedic and Sports Physical Therapy
Kristen M Sochol, Daniel A Charen, Steven M Andelman, Bradford O Parsons
No abstract text is available yet for this article.
April 30, 2018: Journal of Shoulder and Elbow Surgery
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