Total shoulder inverted

BACKGROUND: Periprosthetic joint infections occur in 1-4% of primary total shoulder arthroplasties (TSAs). Cutibacterium acnes (C. acnes) is the most commonly-implicated organism and has been shown to persist in the dermis despite use of preoperative antibiotics and standard skin preparations. Studies have shown decreased rates of positive C. acnes cultures with use of preoperative benzoyl peroxide (BPO) or hydrogen peroxide (H2O2), but positive deep cultures remain common. We sought to determine if an additional application of H2O2 directly to the dermis following skin incision would further decrease deep culture positivity rates...

BACKGROUND: The ideal timing between bilateral total shoulder arthroplasty (TSA) is unclear. The purpose of this study is to determine whether early outcomes after 1st TSA can be used to predict clinical outcomes after TSA of the contralateral shoulder and to evaluate the ideal time after TSA to perform the contralateral shoulder. METHODS: A single-institution prospectively-collected shoulder arthroplasty database was reviewed. Patients undergoing bilateral primary anatomic or reverse TSA (aTSA+rTSA) without an indication of fracture, tumor, or infection were identified...

BACKGROUND: Restoration of external (ER) and internal rotation (IR) after Grammont-style reverse shoulder arthroplasty (RSA) is often unreliable. The purpose of this systematic review was to evaluate the influence of RSA medio-lateral offset and subscapularis repair on axial rotation after RSA. METHODS: We conducted a systematic review of studies evaluating axial rotation (ER, IR, or both) after RSA with a defined implant design. Medio-lateral implant classification was adopted from Werthel et al...

BACKGROUND: When patients require reoperation after primary shoulder arthroplasty, revision reverse total shoulder arthroplasty (rTSA) is most commonly performed. However, defining clinically important improvement in these patients is challenging because benchmarks have not been previously defined. Furthermore, while the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) are commonly utilized to assess clinically relevant success, these metrics are limited by ceiling effects which may cause inaccurate estimates of patient success...

INTRODUCTION: Patients are increasingly undergoing bilateral total shoulder arthroplasty (TSA). At present, it is unknown whether success after the 1st TSA is predictive of success after contralateral TSA. We aimed to determine whether exceeding clinically important thresholds of success after primary TSA predicts similar outcomes for subsequent contralateral TSA. METHODS: We performed a retrospective review of a prospectively-collected shoulder arthroplasty database for patients undergoing bilateral primary anatomic (aTSA) or reverse (rTSA) total shoulder arthroplasty since January 2000 with preoperative and 2- or 3-year clinical follow-up...

BACKGROUND: Anatomic and reverse total shoulder arthroplasty (aTSA, rTSA) are well-established treatments for patients with primary osteoarthritis and an intact cuff. However, it is unclear whether aTSA or rTSA provide superior outcomes in patients with preoperative external rotation (ER) weakness. METHODS: A retrospective review of a prospectively collected shoulder arthroplasty database was performed between 2007-2020. Patients were excluded for preoperative diagnoses of nerve injury, infection, tumor, or fracture...

Background The inconsistent morphology of the scapula is based on variable dimensions of its glenoid cavity, in addition to its broadened and truncated lateral angle. Its variable shapes are attributed to the spinoglenoid cavity (superior and posterior aspect of the scapula), which appears oval, inverted comma-shaped, and piriform (pear-shaped). Traumatic conditions often lead to glenoid dislocation/fracture. The precise administration of total shoulder arthroplasty with glenoid component adjustment warrants a comprehensive knowledge of scapular morphology...

BACKGROUND: When patients require revision of primary shoulder arthroplasty, revision reverse total shoulder arthroplasty (rTSA) is most commonly performed. However, defining clinically-important improvement in these patients is challenging because benchmarks have not been previously defined. Our purpose was to define the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) for outcome scores and range of motion (ROM) after revision rTSA and to quantify the proportion of patients achieving clinically-relevant success...

BACKGROUND: Failure of a subscapularis repair construct after anatomic total shoulder arthroplasty can result in difficulty with internal rotation and an increased likelihood of dislocation. Although suture tape has been demonstrated to be an efficacious augment for tendonous repairs elsewhere in the body, it has not been investigated as a method for augmenting subscapularis peel repairs. PURPOSE: To determine the biomechanical efficacy of suture tape augmentation for the repair of a subscapularis peel...

BACKGROUND: While most patients undergoing reverse total shoulder arthroplasty (rTSA) have substantial improvement in pain and function at early follow-up, improvements in pain and range of motion (ROM) progress more slowly during postoperative rehabilitation in a subset of patients. The purpose of this study was to define a patient's risk of persistent shoulder dysfunction beyond the early postoperative period and identify risk factors for persistent poor performance. METHODS: We retrospectively reviewed 292 primary rTSAs with early poor performance and a preoperative diagnosis of osteoarthritis, cuff-tear arthropathy, or rotator cuff tear from a multicenter database...

BACKGROUND: Nerve injury following reverse shoulder arthroplasty (RSA) is a known risk factor with wide ranging incidences reported. This systematic review evaluates the overall incidence of nerve injury following primary and revision RSA and summarizes the characteristics of the nerve injuries reported in the current literature. METHODS: A systematic review was performed using separate database searches (Pubmed, Embase, Web of Science, Cochrane) following the PRISMA guidelines...

Introduction: Rotator cuff tendons are typically reattached to the proximal humerus using transosseous sutures or suture anchors. Their primary mode of failure is at the tendon-bone interface. Methods: We investigated the addition of an adhesive, gelatin-resorcin-formalin (GRF) glue, to a single-row rotator cuff repair (RCR) on ex vivo sheep models. We hypothesised the addition of GRF glue would increase the repair construct strength. The study consisted of three groups of six sheep infraspinatus tendons with an inverted-mattress stitch, tension-band configuration...

The Greater Rhea (Rhea americana, Rheidae) is a flightless paleognath with a wide geographical distribution in South America. The morphology of its shoulder girdle and wings are different from those of flying birds and some characteristics are similar to basal birds and paravian theropods. We present a detailed osteological, myological, and functional study of the shoulder and the wing of the Greater Rhea. Particular features of the anatomy of the pectoral girdle and wing of Rhea include the lack of triosseal canal, reduced origin area of the mm...

BACKGROUND: Scapular notching is a common complication of reverse total shoulder arthroplasty (RTSA). Inverted-bearing RTSA (IB-RTSA) systems, with polyethylene (PE) glenospheres and metal or ceramic humeral liners, reduce notching and PE wear compared with traditional Grammont prosthesis designs. However, whether notching after IB-RTSA influences clinical outcomes or complications remains unknown. Therefore, we evaluated the influence of notching on midterm clinical outcomes and complication rates after IB-RTSA...

Background: Reverse shoulder arthroplasty is becoming an increasingly common surgical procedure in Hong Kong, as well as in many other countries worldwide. The aim of this study is to describe the glenoid anatomy in the Southern Chinese population. We are interested to know whether commercially available glenoid implants are suitable for this population and whether there are any steps or precautions we can take during surgery to optimize the clinical outcome for these patients. Method: A total of 244 shoulders of Southern Chinese patients were analyzed using 2-dimensional computed tomography, formatted to align along the scapular axis...

BACKGROUND: The glenoid cavity is a sliced egg-shaped joint surface located on the lateral margin of the scapula to form the shoulder joint. Antero-superior notch affects the morphology of the glenoid cavity. Recognition of variations in shape and dimensions of the glenoid cavity is important for better comprehension of joint-associated diseases, especially in total shoulder arthroplasty procedures. The aim of this study was to perform morphometric measurements on the glenoid cavity through Multi-detector Computed Tomography images...

INTRODUCTION: Reverse total shoulder arthroplasty (RTSA) is a widely recognized treatment to reduce pain and improve shoulder function for patients in various disease stages of cuff tear arthropathy (CTA). However, it remains unclear whether outcomes after RTSA depend on the preoperative stage of CTA. Therefore, this study evaluated whether the Hamada classification influences midterm clinical outcomes after RTSA. MATERIALS AND METHODS: In this multicenter observational study, patients underwent inverted bearing RTSA for massive rotator cuff tears or CTA...

Background: Glenoid component failures still represent the most common complication in total shoulder arthroplasty. These failures depend on several factors, including ultra-high molecular weight polyethylene (UHMWPE) wear. One reason for UHMWPE wear in total shoulder arthroplasty may be the current use of a spherical prosthetic humeral head against a radially mismatched UHMWPE glenoid component, which leads to reduced glenohumeral translations, glenoid edge loading and high translational forces during shoulder motions...

STATEMENT OF PROBLEM: Selective laser melting (SLM) technology has been introduced for printing metal dental restorations from Co-Cr base alloys or Au-Pt high noble alloys. However, information regarding the fit of restorations fabricated by using this technique is limited. PURPOSE: The purpose of this in vitro study was to determine the effect of 3 different finish line designs on the marginal and internal gaps of metal copings made from a base (Co-Cr), high noble (Au-Pd-Ag), and noble alloy (Co-Pd) by using the SLM technology...

Glenoid component stability is essential to ensure successful long-term survivability following total shoulder arthroplasty. As such, this computational study assessed the stability of five all-polyethylene glenoid components (Keel, Central-Finned 4-Peg, Peripheral 4-Peg, Cross-Keel, and Inverted-Y), using simulated joint loading in an osteoarthritic patient cohort. Stability was assessed on the basis of component micromotion in the tangential and normal directions. Maximum tangential micromotion occurred in the Cross-Keel (146 ± 46 µm), which was significantly greater (p < ...