Shoulder and Elbow最新文献

{"title":"Depression screening within 3 months of primary shoulder arthroplasty decreases medical complications, implant complications, and costs of care in patients with diagnosed depressive disorder.","authors":"Adam M Gordon, Faisal R Elali, Chaim Miller, Jake M Schwartz, Jack Choueka","doi":"10.1177/17585732231217704","DOIUrl":"10.1177/17585732231217704","url":null,"abstract":"<p><strong>Background: </strong>It is unknown if nonpharmacologic interventions are protective of adverse outcomes in depression patients. We studied whether depression screenings/psychotherapy visits were associated with lower: (a) medical complications, (b) readmission rates, (c) implant-related complications, and (d) healthcare expenditures.</p><p><strong>Methods: </strong>A nationwide claims database was queried for primary shoulder arthroplasty from 2010 to 2020. Depression patients included those who had (n  =  3566) and did not have (n  =  17,769) a pre-operative depression screen/psychotherapy visit within 3 months of shoulder arthroplasty. A 90-day period was utilized for complications and readmissions. Implant complications were assessed over 2 years. Costs were surgeon reimbursements. Logistic regression models computed odds ratios (OR) of complications and readmissions. <i>P</i>-values less than 0.005 were significant.</p><p><strong>Results: </strong>Depression patients who did not undergo screening had threefold higher odds of 90-day medical complications (28.08 vs. 7.26%; OR: 3.33, <i>p</i> < 0.0001). Readmissions (3.97 vs. 3.48%; <i>p</i>  =  0.719) were similar between non-screened vs. screened patients. Implant complications were higher among non-screened vs. screened patients (15.89 vs. 8.02%; OR: 1.93, <i>p</i> < 0.0001), including prosthetic joint infections (2.05 vs. 0.93%; OR: 2.04, <i>p</i> < 0.0001). Costs were significantly higher in patients without screening ($10,916 vs $8703; <i>p</i> < 0.0001).</p><p><strong>Discussion: </strong>Shoulder arthroplasty surgeons may consider counseling their depression patients about the importance of having a recent screening by their physician.<b>Level of Evidence:</b> III.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"17 2","pages":"158-165"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to Abstracts for the 36th Annual Scientific Meeting BESS 2024.","authors":"","doi":"10.1177/17585732251331093","DOIUrl":"https://doi.org/10.1177/17585732251331093","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/17585732241291698.].</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251331093"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of smoking on shoulder arthroplasty outcomes: A meta-analysis of postoperative complications.","authors":"Rafael Llombart-Blanco, Gonzalo Mariscal, Ibrahim Khalil, Carlos Barrios, Rafael Llombart-Ais","doi":"10.1177/17585732251327368","DOIUrl":"10.1177/17585732251327368","url":null,"abstract":"<p><strong>Introduction: </strong>Although advancements in surgical techniques and postoperative management have improved outcomes, the impact of smoking on shoulder arthroplasty outcomes remains controversial. This study aimed to evaluate the influence of smoking on shoulder arthroplasty outcomes and provide a clearer perspective on the controversy surrounding the impact of smoking on medical and surgical complications.</p><p><strong>Methods: </strong>A systematic search was conducted using four Library databases. PROSPERO (CRD42023444819). The quality of the studies was assessed using the Methodological Index for Non-randomized Studies. Odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated for the dichotomous and continuous variables. This study used the PICOS strategy to identify studies with patients undergoing shoulder arthroplasty surgery, with smoking as the intervention, non-smoking as the comparison, and postoperative complications as the outcome.</p><p><strong>Results: </strong>The meta-analysis included eight studies with 227,329 patients. The smoking group had a higher risk of readmission (OR: 1.11, 95% CI [1.05-1.17]), revision (OR: 2.32, 95% CI [1.28-4.23]), periprosthetic fracture (OR: 1.38, 95% CI [1.24-1.53]), and surgical site infection (OR: 2.09, 95% CI [1.77-2.47]), but no significant differences were found in wound problems or thromboembolic events. The smoking group had a higher risk of sepsis (OR: 1.31, 95% CI [1.07-1.60]). There were no significant differences in renal complications, urinary tract infections, pulmonary complications, or myocardial infarctions between the two groups.</p><p><strong>Conclusion: </strong>Smoking is a modifiable risk factor that should be addressed to improve outcomes and reduce the costs associated with complications and joint replacement in patients undergoing shoulder arthroplasty.</p><p><strong>Implications: </strong>These findings emphasize the need to promote a tobacco-free lifestyle and improve surgical outcomes. Preoperative interventions should include education, counseling, and support, fostering better shoulder arthroplasty results and long-term well-being.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251327368"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review, and meta-analysis of pain outcomes following total elbow replacement and hemi-replacement for unreconstructible acute distal humerus fractures in adults.","authors":"Adam C Watts, Zaid Hamoodi, Andrew C Wright, Catriona M McDaid, Catherine E Hewitt","doi":"10.1177/17585732251328594","DOIUrl":"10.1177/17585732251328594","url":null,"abstract":"<p><strong>Background: </strong>Unreconstructible distal humerus fractures have been managed with total elbow replacement (TER), but there is increasing use of hemi-replacement (DHH). Pain has been identified as the most important outcome by patients. This study aims to systematically review the literature on reported pain outcomes in adult distal humerus fractures treated with TER or DHH.</p><p><strong>Methods: </strong>Medline, Embase and Central were searched using OVID, from January 2000 to September 2023, for studies in adults undergoing DHH or TER for acute closed distal humerus fractures. The primary outcome was patient-rated pain measured on a numerical rating scale. A quantitative summary of reported outcomes was stratified by intervention type.</p><p><strong>Results: </strong>Twenty-three studies met the inclusion criteria, including one published randomised controlled trial. Meta-analysis found a pooled average NRS pain for TER of 1.7/10 (95% CI: 0.44-2.99) and 1.5/10 for DHH (95% CI: 0.001-3.56). On a 4-point Likert scale the pooled probability of no pain, mild pain, moderate pain, severe pain for TER was 0.75, 0.21, 0.02, 0.00 and for DHH was 0.76, 0.11, 0.12, and 0.00.</p><p><strong>Discussion: </strong>The available evidence does not enable comparison of pain outcomes between the interventions, which should be assessed in an appropriately powered randomised trial.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251328594"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring patient perspectives, socioeconomic status and beliefs on rehabilitation after arthroscopic rotator cuff repair: A qualitative study.","authors":"Madhushree S Nayak, B Anupama Prabhu, M Ganesh Balthillaya, Preetha Ramachandra, Deepalaxmi P Poojari, Shwetha Ts, James M Elliott, Mira Meeus","doi":"10.1177/17585732251327175","DOIUrl":"10.1177/17585732251327175","url":null,"abstract":"<p><strong>Background: </strong>Arthroscopic rotator cuff repair (ARCR) surgery is often recommended to reduce pain, restore function, and improve quality of life in patients with rotator cuff tears. Several factors can influence how effectively patients manage their pain, follow rehabilitation guidelines, and perceive their overall recovery, including patient perspectives, socioeconomic status, and beliefs on rehabilitation. Understanding these characteristics is crucial to optimizing patient outcomes and modifying rehabilitation approaches to meet specific patient requirements.</p><p><strong>Objective: </strong>To obtain an in-depth understanding of patient perspectives, socioeconomic status, and beliefs on rehabilitation after ARCR.</p><p><strong>Methods: </strong>This qualitative study consisted of face-to-face semi-structured interviews with 13 participants who underwent ARCR. Interviews were recorded, transcribed, and analysed using a six-step approach as proposed by Braun and Clarke.</p><p><strong>Results: </strong>The mean age of the included participants was 53 ± 8.07 years, with 76% being male with most of the participants belonging to lower middle and upper lower socioeconomic status. Three major themes emerged from the interview: 1) Role of healthcare provider, 2) Socio-environmental factors, and 3) Cognitive-behavioural response.</p><p><strong>Conclusion: </strong>Our findings imply that rehabilitation strategies should incorporate a more comprehensive patient-centred approach that considers a wider range of factors influencing compliance with therapy and overall rehabilitation.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251327175"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in wear patterns in primary elbow osteoarthritis.","authors":"Yiyang Zhang, Nicholas Chang, Kenneth J Faber, George S Athwal, Graham Jw King","doi":"10.1177/17585732251327183","DOIUrl":"10.1177/17585732251327183","url":null,"abstract":"<p><strong>Background: </strong>We have observed differences in patterns of arthritic wear between male and female patients undergoing arthroscopic management of elbow osteoarthritis. The objective of the study was to examine sex-related radiographic differences in symptomatic primary elbow osteoarthritis through a matched cohort study.</p><p><strong>Methods: </strong>Fifty patients with primary elbow osteoarthritis that required surgery were identified and divided into two cohorts matched by sex and age from an institutional database. Basic patient demographics were recorded. The minimum joint space width (JSW) of the radiocapitellar and ulnohumeral compartments were measured on coronal and sagittal CT images, by two reviewers.</p><p><strong>Results: </strong>The mean age of the 50 patients was 56 <math><mo>±</mo> <mn>6</mn></math> years. The mean size adjusted ulnohumeral JSW for males was 1.5 <math><mo>±</mo> <mn>0.4</mn></math>  mm and females was 1.0 <math><mo>±</mo> <mn>0.5</mn></math>  mm, <i>p</i> = 0.003. The mean size adjusted radiocapitellar JSW for males was 1.1 <math><mo>±</mo> <mn>0.6</mn></math>  mm and females was 1.3 <math><mo>±</mo> <mn>0.7</mn></math>  mm, <i>p</i> = 0.37. Comparing radiocapitellar and ulnohumeral JSW within each sex, radiocapitellar JSW was significantly narrower in males (<i>p</i> = 0.008) but the radiocapitellar and ulnohumeral JSW was similar in females (<i>p</i> = 0.11).</p><p><strong>Conclusion: </strong>In our study, we found that male patients with primary elbow osteoarthritis had cartilage loss predominantly in the radiocapitellar articulation. Female patients had similar radiocapitellar and ulnohumeral JSW suggesting more symmetric cartilage wear.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251327183"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic or reverse shoulder arthroplasty for cuff intact glenohumeral osteoarthritis.","authors":"Yousif Atwan, Michael J Walton, Adam C Watts, Ian A Trail","doi":"10.1177/17585732251319977","DOIUrl":"https://doi.org/10.1177/17585732251319977","url":null,"abstract":"<p><p>Glenohumeral osteoarthritis in the presence of an intact rotator cuff is a debilitating condition that often leads to surgical intervention in the form of joint arthroplasty. Historically, anatomic total shoulder replacement (ATSR) had been considered the treatment of choice. Over the past decade, however, there has been a shift in treatment patterns to the use of reverse shoulder replacement to treat this condition due to concerns of subsequent rotator cuff failure and glenoid component loosening with ATSR. With continued innovation of implants and surgical techniques, it is unclear which procedure provides the best outcomes for patients. The Reverse or Anatomical replacement for Painful Shoulder Osteoarthritis, Differences between Interventions trial aims to definitively answer this question and evaluate the cost effectiveness of both procedures.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251319977"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current evidence on hyaluronic acid injections for rotator cuff tendinopathy: A scoping review.","authors":"Alexandre Lavigne, Edmond Sandouk, Andrew Hiett, Min Cheol Chang, Valérie Bélanger, Martin Lamontagne, Michael Khadavi","doi":"10.1177/17585732251324484","DOIUrl":"https://doi.org/10.1177/17585732251324484","url":null,"abstract":"<p><strong>Introduction: </strong>There is growing evidence that hyaluronic acid (HA) injections can significantly improve pain and function in rotator cuff tendinopathy. However, there is no consensus regarding the optimal parameters for HA injections. This narrative review explores the procedural considerations for HA injections in rotator cuff tendinopathy.</p><p><strong>Methods: </strong>A literature search using Pubmed and Cochrane was conducted to assess procedural considerations for HA injections in rotator cuff tendinopathy including the type of HA (linear vs. cross-linked), the molecular weight (low, moderate, and high), the combination of HA with other products, the number and frequency of injections, the injection guidance, and the adverse effects.</p><p><strong>Results: </strong>Nine randomized-controlled trials and two prospective non-randomized studies assessed the efficacy of HA injections for rotator cuff tendinopathy, and their characteristics were thoroughly analyzed. Two studies compared the efficacy of different molecular weight HA. One study assessed the efficacy of HA combined with extracorporeal shockwave therapy.</p><p><strong>Conclusion: </strong>Highlights of the findings include the clinical benefits of HA injections for rotator cuff tendinopathy, the better tolerability of low molecular weight HA compared to high molecular weight, the safer adverse effect profile of HA compared to glucocorticoid injections, and the synergistic effect of HA and extracorporeal shockwave therapy.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251324484"},"PeriodicalIF":1.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shoulder girdle neoplasm misdiagnosis and clinical manifestations: A scoping review.","authors":"Michael S Wilkinson, Steven J Obst","doi":"10.1177/17585732251324656","DOIUrl":"https://doi.org/10.1177/17585732251324656","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this review is to outline the clinical presentation of patients with shoulder girdle neoplasm to help differentiate it from frozen shoulder contracture syndrome (FSCS) as well as quantify misdiagnosis rates in the literature.</p><p><strong>Methods: </strong>Four electronic databases were searched (Embase, Medline, PUBMED and Scopus) for cohort studies of patients with shoulder girdle neoplasm with or without misdiagnosis as FSCS in line with the PRISMA-ScR guidelines for scoping reviews.</p><p><strong>Results: </strong>The initial search yielded 2462 studies, 10 of which were included in the final review. The most common symptom of patients with shoulder girdle neoplasm was shoulder pain (62%) followed by swelling/mass/deformity (34%) and local/bony tenderness (13%). In patients with neoplasm initially misdiagnosed as FSCS the main complaints were shoulder pain and subjective stiffness/loss of range of motion (73% each). Misdiagnosis rates ranged from 10% to 50% and resulted in diagnostic delays of up to 30 months.</p><p><strong>Conclusions: </strong>Key clinical features of bone and soft tissue tumours such as local bony tenderness and careful observation for swelling/mass/deformity should be included in the physical examination to help differentiate between the two pathologies and help guide the choice of initial imaging for the primary contact clinician.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251324656"},"PeriodicalIF":1.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angular stable intramedullary nail versus locking plate fixation of osteoporotic surgical neck proximal humerus fractures: A biomechanical comparison.","authors":"Eric Samuelson, Elizabeth Lyden, Hani Haider, Armodios M Hatzidakis, Timothy Lackner, Bradford Zitsch, Edward V Fehringer","doi":"10.1177/17585732251324497","DOIUrl":"https://doi.org/10.1177/17585732251324497","url":null,"abstract":"<p><strong>Background: </strong>Our study's purpose was to compare biomechanical performances of a proximal humerus locking plate (PHLP) with an antegrade intramedullary nail (IMN) in an osteoporotic two-part surgical neck proximal humerus fracture model.</p><p><strong>Methods: </strong>Simulated fractures were made through the surgical neck of synthetic osteoporotic humeri. One group had identical transverse fractures instrumented with a PHLP with seven screws (PHLP-7; <i>n</i> = 4), a PHLP with nine screws (PHLP-9; <i>n</i> = 2), or an IMN (<i>n</i> = 4). Each underwent pre-fatigue testing, an identical fatigue protocol, and post-fatigue testing. A second high oblique fracture line was tested identically with PHLP-9 (<i>n</i> = 4) and IMN (<i>n</i> = 4) constructs.</p><p><strong>Results: </strong>Statistical analyses of transverse specimen pre-fatigue stiffness revealed that the PHLP-7 and PHLP-9 were stiffer in anteroposterior bending and torsion compared to the IMN. There was no difference between the three constructs in varus-valgus bending or compression. Post-fatigue stiffness comparisons revealed no difference between the three constructs. For the oblique fracture, pre-fatigue differences were found with the IMN stiffer in varus-valgus bending and the PHLP-9 stiffer in torsion.</p><p><strong>Discussion: </strong>The biomechanical performance of an angular-stable proximal humeral nail design was comparable, especially following fatigue, to locked plate/screw constructs in a synthetic osteoporotic two-part surgical neck proximal humerus fracture model.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251324497"},"PeriodicalIF":1.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}