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Reverse total shoulder arthroplasty

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https://www.readbyqxmd.com/read/29214382/bleeding-in-primary-shoulder-arthroplasty
#1
Dominik Malcherczyk, Asma Abdelmoula, Thomas J Heyse, Christian D Peterlein, Brandon Greene, Bilal F El-Zayat
INTRODUCTION: The aim of this investigation was to analyse "total blood loss" (TBL), "blood transfusion rate" (BT) and the "amount of transfused blood units" (BU) between the different primary shoulder arthroplasty (SA) types: reverse, anatomical and stemless. Only primary SA was included. Further goal was to identify risk factors for TBL, amount of BU and BT rate. METHODS: A retrospective charts analysis of patients who received primary SA for degenerative shoulder pathology in our institution between 2004 and 2016 was performed...
December 6, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29204822/the-experience-of-the-ripo-a-shoulder-prosthesis-registry-with-6-year-follow-up
#2
G Porcellini, A Combi, G Merolla, B Bordini, S Stea, G Zanoli, P Paladini
BACKGROUND: Implant registries have proved valuable in assessing the outcomes of arthroplasty procedures. Moreover, by identifying lesser quality implants they have indirectly improved the quality of care. The registry of prosthetic shoulder implants was established in 2008. METHODS: It records information on all types of primary and revision arthroplasty procedures involving the glenohumeral joint, including reverse and total arthroplasty, hemiarthroplasty, resurfacing, removal, and any other surgical procedures that are required to manage these patients...
December 4, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/29198353/editorial-commentary-when-the-shoulder-joint-has-lost-stoichiometry-does-arthroscopic-assisted-latissimus-dorsi-transfer-stack-up
#3
EDITORIAL
Robert D Graham
Non-arthroplasty treatment options for pseudoparalysis of the shoulder are preferable in the younger patient population. Although there are differing philosophies among shoulder surgeons, many prefer to avoid reversed total shoulder arthroplasty for patients under age 60 years. Arthroscopically assisted latissimus dorsi transfer may be a good alternative for these patients, but how the results compare with arthroscopic superior capsular reconstruction is the question.
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29162305/quantifying-success-after-total-shoulder-arthroplasty-the-minimal-clinically-important-difference
#4
Ryan Simovitch, Pierre-Henri Flurin, Thomas Wright, Joseph D Zuckerman, Christopher P Roche
BACKGROUND: Knowledge of the minimal clinically important difference (MCID) for different shoulder outcome metrics and range of motion after total shoulder arthroplasty (TSA) can be useful to establish a minimum threshold of improvement that defines successful treatment. This study quantifies how MCID varies with different prosthesis types, patient age, gender, and length of follow-up after TSA. METHODS: A total of 466 anatomic TSA (aTSA) and reverse TSA (rTSA) with 2-year minimum follow-up were performed by 13 shoulder surgeons...
November 18, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29155311/glenoid-exposure-in-total-shoulder-arthroplasty
#5
REVIEW
L Nové-Josserand, P Clavert
Glenoid exposure is agreed to be a difficult step, but is also a key step in total shoulder arthroplasty, both anatomic and reverse. It conditions unhindered use of the ancillary instrumentation and thus correct glenoid component positioning. The main stages comprise arthrotomy, by opening the rotator cuff, humeral head cut, and inferior glenohumeral release, enabling shifting of the humerus and good exposure of the glenoid cavity. The two main approaches are deltopectoral and anterosuperior transdeltoid. Using the deltopectoral approach, arthrotomy is performed through the subscapularis muscle, by various techniques...
November 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29152007/shoulder-arthroplasty-imaging-what-s-new
#6
REVIEW
T M Gregory, J Gregory, E Nicolas, J Pierrart, E Masmejean
Background: Shoulder arthroplasty, in its different forms (hemiarthroplasty, total shoulder arthroplasty and reverse total shoulder arthroplasty) has transformed the clinical outcomes of shoulder disorders. Improvement of general clinical outcome is the result of stronger adequacy of the treatment to the diagnosis, enhanced surgical techniques, specific implanted materials, and more accurate follow up. Imaging is an important tool in each step of these processes. Method: This article is a review article declining recent imaging processes for shoulder arthroplasty...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29152006/anatomic-shoulder-arthroplasty-technical-considerations
#7
REVIEW
Bogdan A Matache, P Lapner
Osteoarthritis of the shoulder is a common condition in the aging population, and it can have profound effects on patients' quality of life. The anatomic total shoulder arthroplasty is a well-described treatment modality resulting generally excellent outcomes. The objective of this review is to discuss the technical aspects of primary anatomic total shoulder arthroplasty, and to provide a framework to follow to achieve a successful surgical result. The topics covered include preoperative planning, surgical considerations, and approaches, humeral preparation, glenoid bone loss and the emerging concept of using the reverse total shoulder arthroplasty for the type B2 glenoid...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29138871/revision-shoulder-arthroplasty-with-a%C3%A2-reverse-shoulder-prosthesis-use-of-structural-allograft-for-glenoid-bone-loss
#8
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...
December 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29133073/comparing-daily-shoulder-motion-and-frequency-after-anatomic-and-reverse-shoulder-arthroplasty
#9
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/29130873/influence-of-body-mass-index-on-clinical-outcomes-in-reverse-total-shoulder-arthroplasty
#10
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/29103059/fatty-degeneration-of-the-deltoid-muscle-associated-with-displaced-proximal-humerus-fractures
#11
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/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/29051900/previous-rotator-cuff-repair-is-associated-with-inferior-clinical-outcomes-after-reverse-total-shoulder-arthroplasty
#13
Edward J W Shields, Denise M Koueiter, Tristan Maerz, Adam Schwark, J Michael Wiater
BACKGROUND: Although recent evidence suggests that any prior shoulder surgery may cause inferior shoulder arthroplasty outcomes, there is no consensus on whether previous rotator cuff repair (RCR) is associated with inferior outcomes after reverse total shoulder arthroplasty (RTSA). PURPOSE: To retrospectively compare outcomes in patients who underwent RTSA with and without previous RCR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients with prior RCR and those without previous shoulder surgery (control) who underwent RTSA for cuff tear arthropathy or irreparable cuff tear were retrospectively identified from a prospective database...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29046778/ultrasound-guided-percutaneous-cryoneurolysis-providing-postoperative-analgesia-lasting-many-weeks-following-a-single-administration-a-replacement-for-continuous-peripheral-nerve-blocks-a-case-report
#14
Brian M Ilfeld, Rodney A Gabriel, Andrea M Trescot
Cryoneurolysis entails using low temperatures to reversibly ablate nerves, with a subsequent analgesia duration measured in weeks or months. Previously, clinical applications for acute pain were limited because treatment originally required exposing the target nerve surgically. However, three developments have now made it possible to provide prolonged postoperative analgesia by cryoneurolysis: 1) new portable, hand-held cryoneurolysis devices, 2) ultrasound machine proliferation, and, 3) anesthesiologists trained in ultrasound-guided peripheral nerve block administration...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046255/platform-shoulder-arthroplasty-a-systematic-review
#15
Jacob M Kirsch, Moin Khan, Patrick Thornley, Mark Gichuru, Michael T Freehill, Andrew Neviaser, James Moravek, Bruce S Miller, Asheesh Bedi
BACKGROUND: Platform shoulder arthroplasty systems may allow conversion to a reverse total shoulder arthroplasty (RTSA) without removing a well-fixed, well-positioned humeral stem. We sought to evaluate the complications associated with humeral stem exchange versus retention in patients undergoing conversion shoulder arthroplasty with a platform shoulder arthroplasty system. METHODS: PubMed, MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Embase were searched from database inception through October 9, 2016, for all articles comparing humeral stem retention versus exchange during conversion RTSA or that pertained to conversion RTSA with stem retention alone...
October 15, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29040126/reverse-total-shoulder-arthroplasty-for-massive-irreparable-rotator-cuff-tears-before-the-age-of-60-years-long-term-results
#16
Lukas Ernstbrunner, Aline Suter, Sabrina Catanzaro, Stefan Rahm, Christian Gerber
BACKGROUND: There has been serious concern regarding the longevity and durability of outcomes of reverse total shoulder arthroplasty (RTSA) in younger patients. It was the purpose of this study to analyze long-term outcomes and complications of RTSA for irreparable rotator cuff tears in patients younger than 60 years. METHODS: Twenty patients (23 shoulders) with a mean age of 57 years (range, 47 to 59 years) were evaluated at a mean of 11.7 years (range, 8 to 19 years) after RTSA...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28988351/management-of-complex-anterior-shoulder-instability-a-case-based-approach
#17
REVIEW
Nathan Olszewski, Michael Gustin, Emily J Curry, Xinning Li
PURPOSE OF THE REVIEW: The goal of this review is to provide a guide on surgical decision-making options for complex anterior shoulder instability using a case-based approach. RECENT FINDINGS: Arthroscopic Bankart repair is well documented for having successful outcomes in patients with isolated labral tear involvement with minimal bone loss. Latarjet is a generally accepted procedure in patients with 20-30% glenoid bone loss. When bone loss exceeds that which cannot be managed through Latarjet, a range of options exist and are highly dependent upon the extent of osseous deficiency on both the glenoid and humeral sides, surgeon experience, and patient-specific factors...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28986684/reverse-shoulder-arthroplasty-in-obese-patients-analysis-of-functionality-in-the-medium-term
#18
Alberto Izquierdo-Fernández, José Carlos Minarro, Rocío Carpintero-Lluch, Ester María Estévez-Torres, Pedro Carpintero-Benítez
INTRODUCTION: Obesity is an epidemic nowadays and this fact conditions results in orthopaedic surgery. Very few studies evaluates if obesity is a risk factor for reverse shoulder arthroplasty. The aim of this study is to confirm if there are differences with regard to the outcomes in patients undergoing reverse shoulder arthroplasty according to their body mass index (BMI). MATERIALS AND METHODS: A total of 35 patients were enrolled in the study. Then divided into subpopulations according to their BMI and analyzed twice...
October 6, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28970669/how-does-reverse-shoulder-replacement-change-proprioception-in-patients-with-cuff-tear-arthropathy-a-prospective-optical-3d-motion-analysis-study
#19
Pit Hetto, Matthias Bülhoff, Boris Sowa, Matthias C Klotz, Michael W Maier
BACKGROUND: Reverse total shoulder arthroplasty (RSA) can improve function in cuff tear arthropathy (CTA) shoulders, but limited data are available on the effect of RSA on proprioception. The purpose of this study was the evaluation of the proprioception after RSA. METHOD: This study included fifteen consecutive patients (n = 15) who received an RSA. We measured an active angle reproduction (AAR) by a novel 3D motion analysis using the Heidelberg upper extremity model (HUX)...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28968474/increasing-use-of-reverse-total-shoulder-arthroplasty-for-proximal-humerus-fractures-in-elderly-patients
#20
Sean S Rajaee, Dheeraj Yalamanchili, Naudereh Noori, Eytan Debbi, James Mirocha, Carol A Lin, Charles N Moon
This study described surgical treatment patterns for proximal humerus fractures among elderly patients, focusing on reverse total shoulder arthroplasty (TSA), and evaluated how the type of fixation affects inpatient factors (cost, length of stay), transfusion rates, and patient disposition (home vs skilled nursing facility). With Nationwide Inpatient Sample data from 2011 to 2013, the authors identified patients 65 years and older who had proximal humerus fractures and divided them into 3 groups: (1) open reduction and internal fixation (ORIF); (2) hemiarthroplasty; and (3) reverse TSA...
October 2, 2017: Orthopedics
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