Shoulder and Elbow最新文献_第2页

Functional outcomes and complications after locked plating of fracture-dislocations of the proximal humerus and the significance of the intertuberosity periosteal bridge. 肱骨近端骨折脱位锁定钢板后的功能结局及并发症及结节间骨膜桥的意义。

IF 1.1

Shoulder and Elbow Pub Date : 2025-09-09 DOI: 10.1177/17585732251375394

Dipit Sahu, Aditya Chaubey, Darshil Shah, Ashish Phadnis

{"title":"Functional outcomes and complications after locked plating of fracture-dislocations of the proximal humerus and the significance of the intertuberosity periosteal bridge.","authors":"Dipit Sahu, Aditya Chaubey, Darshil Shah, Ashish Phadnis","doi":"10.1177/17585732251375394","DOIUrl":"10.1177/17585732251375394","url":null,"abstract":"Background: We aimed to evaluate the functional outcomes and complications following locked plating of three- or four-part proximal humerus fracture-dislocations (PHFDs).Methods: We evaluated the functional outcomes and range of motion (ROM) deficit of 26 shoulders with PHFD (AO/OTA 11B1.1(5a), 11B1.1(5b), 11B1.2(5b), 11C3.1(5a), 11C3.1(5b), 11C3.2(5a)), in 25 patients after locking plate fixation. Three patients with avascular necrosis (AVN) of humeral head were followed for one year, and the remaining 22 patients were followed for 24-89 months.Results: At the most recent follow-up, the shoulder subjective value was 77 (60-85), the normalized Constant score was 70 (53-83), the visual analogue scale pain scores were 1 (0-2), the elevation ROM deficit was 35° (13-41), the external rotation ROM deficit was 20° (10-33), and internal rotation ROM (number of vertebrae) deficit was 4 (1-6). AVN was noted in six (23%) shoulders; the shoulders with AVN had worse outcomes than those without AVN. Absent capsular attachments (p < .001), an opened intertuberosity periosteum, and a four-part fracture configuration (p = .004) were significantly associated with AVN.Conclusion: To conclude, functional outcomes after locked plating of fracture-dislocations were acceptable in the majority of the patients. However, complications such as AVN may occur in 23% of patients, leading to poor outcomes.Level of evidence: Level 4; case series.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251375394"},"PeriodicalIF":1.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041765","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}

引用次数: 0

Volume-outcome relationships for primary total elbow arthroplasty surgery in England: Analysis of the hospital episode statistics dataset. 英格兰初次全肘关节置换术的容量-结果关系：医院事件统计数据集分析

IF 1.1

Shoulder and Elbow Pub Date : 2025-09-01 DOI: 10.1177/17585732251360756

Thomas D Stringfellow, David Butt, Deborah Higgs, Mark Falworth, Timothy Wr Briggs, William K Gray

{"title":"Volume-outcome relationships for primary total elbow arthroplasty surgery in England: Analysis of the hospital episode statistics dataset.","authors":"Thomas D Stringfellow, David Butt, Deborah Higgs, Mark Falworth, Timothy Wr Briggs, William K Gray","doi":"10.1177/17585732251360756","DOIUrl":"10.1177/17585732251360756","url":null,"abstract":"Background: Total elbow arthroplasty (TEA) is a low-volume, high-complexity procedure and clinical guidelines recommend moving to a centralised network model. The aim of the study was to assess the effect of surgeon and unit volume on patient and service level clinical outcomes.Methods: Analysis the Hospital Episodes Statistics database (HES) for elective and emergency primary TEA surgery between January 2014 and December 2023 was performed. The exposures of interest were surgeon and trust volume in the 12 months preceding index surgery. The primary outcome was revision surgery within 12 months of index procedure. Secondary outcomes were 30-day emergency readmission and length of stay (LOS) greater than the median.Results: In total, 4101 primary TEA cases performed in 123 trusts were included. One-year revision and 30-day emergency readmission were not associated with trust or surgeon volume. LOS greater than the median showed a significant association with both surgeon and unit TEA volume. Patients undergoing primary TEA by surgeons performing fewer than 10 cases per year have three times the likelihood of LOS over three days.Conclusion: There are significant resource savings from networked service reconfiguration. Careful monitoring of clinical outcomes is required, ideally using patient reported outcomes in addition to implant survival, readmission and LOS.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251360756"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993855","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}

引用次数: 0

Comparison of different surgical stabilization methods in recurrent anterior shoulder injuries in terms of pain, proprioceptive sensation, functional status, and muscle activation. 复发性前肩损伤不同手术稳定方法在疼痛、本体感觉、功能状态和肌肉激活方面的比较。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-28 DOI: 10.1177/17585732251368804

Niran Cakir, Ferruh Taspinar, Mustafa Ozkan, Betul Taspinar

{"title":"Comparison of different surgical stabilization methods in recurrent anterior shoulder injuries in terms of pain, proprioceptive sensation, functional status, and muscle activation.","authors":"Niran Cakir, Ferruh Taspinar, Mustafa Ozkan, Betul Taspinar","doi":"10.1177/17585732251368804","DOIUrl":"10.1177/17585732251368804","url":null,"abstract":"Introduction: This study was designed to compare the outcomes of Bankart, Latarjet, and Remplissage surgical procedures in patients with recurrent anterior shoulder instability.Methods: The study included 26 patients who underwent surgery for recurrent anterior shoulder instability. Pain levels, proprioceptive sensation, functional status, range of motion (ROM), grip strength, and muscle activation were assessed.Results: In our study, the Latarjet procedure demonstrated superior pain control, while Bankart repair was most effective in preserving proprioceptive sensation. Remplissage was the most effective method for improving functional status, showing the highest scores, whereas Latarjet had the lowest scores. In terms of ROM, Bankart repair yielded the most favorable results, whereas Latarjet had the lowest outcomes. Regarding grip strength, remplissage had the highest values, while Latarjet had the lowest. Superficial electromyography measurements indicated variations in activation levels of the deltoid and trapezius muscles, with Bankart repair showing the highest activation levels and Latarjet the lowest.Conclusion: Our findings suggest that Bankart repair is superior in preserving proprioceptive sensation and ROM, whereas Latarjet is more effective in pain control and functional outcomes. Remplissage provided the most favorable results in terms of grip strength and muscle activation.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251368804"},"PeriodicalIF":1.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972664","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}

引用次数: 0

Functional and electrophysiological outcomes following surgical treatment of cubitus varus associated with tardy ulnar nerve palsy: A case series. 手术治疗肘内翻合并迟发性尺神经麻痹后的功能和电生理结果：一个病例系列。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-21 DOI: 10.1177/17585732251369515

Aidin Arabzadeh, Omid Salkhori, Shahram Akrami, Atousa Dachek, Mahsa Arabzadeh, Hamed Naghizadeh

{"title":"Functional and electrophysiological outcomes following surgical treatment of cubitus varus associated with tardy ulnar nerve palsy: A case series.","authors":"Aidin Arabzadeh, Omid Salkhori, Shahram Akrami, Atousa Dachek, Mahsa Arabzadeh, Hamed Naghizadeh","doi":"10.1177/17585732251369515","DOIUrl":"https://doi.org/10.1177/17585732251369515","url":null,"abstract":"Introduction: Cubitus varus deformity, a common late complication of pediatric supracondylar fractures, is often viewed as cosmetic but can lead to functional issues such as tardy ulnar nerve palsy (TUNP). While both conditions have been studied individually, the literature addressing their coexistence and the optimal surgical approach is limited.Method: This study investigates functional and electrophysiological outcomes in patients with concurrent cubitus varus and TUNP who underwent tailored surgical treatment. Eighteen patients were included, treated with combinations of corrective osteotomy and ulnar nerve decompression based on deformity severity and nerve involvement. Outcomes were assessed using DASH scores, McGowan grading, nerve conduction studies, and the Modified Oppenheim Grading System.Results: Postoperatively, significant improvements were observed in functional status, nerve conduction velocity, and sensory latency (p < 0.05). Most patients achieved excellent or good outcomes without major complications. Our results highlight the therapeutic value of individualized surgical planning that addresses both structural deformity and nerve compression, thereby enhancing patient outcomes.Conclusion: To our knowledge, this is among the few studies to comprehensively evaluate clinical, functional, and electrophysiological outcomes in this specific patient group. These findings support the role of combined approaches in improving patient outcomes and provide a framework for future studies on this complex yet underrecognized clinical scenario.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251369515"},"PeriodicalIF":1.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972744","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}

引用次数: 0

Carbon footprint reduction in shoulder surgery by the rationalisation of single-use convenience packs. 通过一次性使用的便利包的合理化，减少肩部手术中的碳足迹。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-19 DOI: 10.1177/17585732251364390

Alex Chowdhury, Ryan Hillier-Smith, Hannah Imran, Rabia Iqbal, Henry B Colaço

{"title":"Carbon footprint reduction in shoulder surgery by the rationalisation of single-use convenience packs.","authors":"Alex Chowdhury, Ryan Hillier-Smith, Hannah Imran, Rabia Iqbal, Henry B Colaço","doi":"10.1177/17585732251364390","DOIUrl":"https://doi.org/10.1177/17585732251364390","url":null,"abstract":"Introduction: The United Kingdom National Health Service is responsible for a vast carbon footprint, with annual carbon dioxide emissions at over 25 million tonnes. Operating theatres contribute up to 25% of a hospital's emissions.Aims: To rationalise the composition of the single-use convenience packs in arthroscopic and open shoulder surgery, to reduce the annual carbon footprint.Methods: The individual material composition of all items in the single-use shoulder arthroscopy and open shoulder convenience packs was considered. The carbon footprint of each item was calculated by the application of best available cradle-to-gate emission factors. The items in the packs were then rationalised by consensus (of surgeons and scrub team). Two new standardised packs were designed.Results: In the 2022/2023 financial year, 296 arthroscopic and 191 open shoulder procedures were performed. The new rationalised open packs had between 3 and 18 fewer items, the new arthroscopic packs 7-8 fewer items. This will result in reduction of 108.9 kg of single use plastics, and an overall annual carbon footprint reduction of 643.8 kgCO2 e.Conclusion: Through a simple method of single-use convenience pack rationalisation, we have reduced the annual carbon footprint of shoulder surgery at our institution. The same methodology is being applied to all orthopaedic packs.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251364390"},"PeriodicalIF":1.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972622","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}

引用次数: 0

Folate deficiency and total shoulder arthroplasty outcomes. 叶酸缺乏和全肩关节置换术的结果。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-18 DOI: 10.1177/17585732251362442

Prasenjit Saha, Seyedeh Zahra Mousavi, Anagh Astavans, Sanjana Agarwal, Henry Fox, Alex Schmucker, Umasuthan Srikumaran

{"title":"Folate deficiency and total shoulder arthroplasty outcomes.","authors":"Prasenjit Saha, Seyedeh Zahra Mousavi, Anagh Astavans, Sanjana Agarwal, Henry Fox, Alex Schmucker, Umasuthan Srikumaran","doi":"10.1177/17585732251362442","DOIUrl":"https://doi.org/10.1177/17585732251362442","url":null,"abstract":"Introduction: Folate deficiency is inversely correlated with inflammatory (markers/conditions) and severe osteoarthritis. Osteoarthritis can lead to increased difficulty in shoulder reconstruction and longer operative times in total shoulder arthroplasty (TSA). Our goal is to see if folate deficiency is correlated with complications after TSA.Methods: A retrospective cohort analysis using the TriNetX database was used to identify individuals with low (≤2.5 ng/mL) and normal (≥2.6 ng/mL) folate levels before TSA. Outcomes were compared at 90 days, two years, and four years following TSA.Results: At 90 days, folate deficient patients had a higher risk of periprosthetic joint infection (11.4% vs 5.9%, RR = 1.944, p = .016), mechanical loosening (3.3% vs 0%, p = .014), periprosthetic fracture (14.4% vs 7.8%, RR = 1.833, p = .011), dislocation (8.5% vs 3.9%, RR = 2.167, p = .021), any mechanical complications (14.1% vs 6.5%, RR = 2.150, p = .002), and instability/subluxation (10.8% vs 5.6%, RR = 1.941, p = .02) when compared to the control group. At the two-year and four-year time points, TSA folate deficient patients had an increased risk of dislocation, any mechanical complications, and instability/subluxation.Discussion: Folate deficiency in TSA patients is correlated with significant short- and long-term increase in several orthopedic complications. Folate deficient patients should be counseled on these risks before TSA.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251362442"},"PeriodicalIF":1.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972710","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}

引用次数: 0

Evaluating tendon transfers in irreparable rotator cuff tears: A systematic review of clinical outcomes and failure rates. 评估肌腱转移在不可修复的肩袖撕裂：临床结果和失败率的系统回顾。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-14 DOI: 10.1177/17585732251368884

Marc Daniel Bouchard, Nikhil Aman Patel, Carl Keogh, Danielle Dagher, Brooke Mackinnon, Sophia Argyropoulos, David Slawaska-Eng, Moin Khan, Bashar Alolabi

{"title":"Evaluating tendon transfers in irreparable rotator cuff tears: A systematic review of clinical outcomes and failure rates.","authors":"Marc Daniel Bouchard, Nikhil Aman Patel, Carl Keogh, Danielle Dagher, Brooke Mackinnon, Sophia Argyropoulos, David Slawaska-Eng, Moin Khan, Bashar Alolabi","doi":"10.1177/17585732251368884","DOIUrl":"10.1177/17585732251368884","url":null,"abstract":"Background: Irreparable rotator cuff tears (IRCTs) pose a clinical challenge, particularly in younger patients. Tendon transfers (TTs) have emerged as a joint-preserving surgical option. However, the clinical outcomes, failure rates, and complication profiles associated with different TTs remain incompletely defined. This systematic review evaluates outcomes across various TT techniques used to manage IRCTs.Methods: A systematic search of MEDLINE, Embase, and Emcare databases was conducted for studies involving adults with diagnosed IRCTs reporting patient-reported outcomes and failure rates following TT. Non-English studies, conference abstracts, case reports, and studies with <12 months follow-up were excluded. Descriptive summaries and pooled analyses were performed by tendon type.Results: Thirty studies (980 patients, 994 shoulders) were included. The mean patient age was 58.9 years, with a mean follow-up of 44.7 months. Latissimus dorsi (LD) transfers were most commonly reported. All tendon types showed significant improvements in patient-reported outcomes. Teres major transfers exhibited the highest Constant-Murley Score improvement (+40) and greatest pain reduction (VAS-5.6), although based on a single study. Failure rates ranged from 4.2% to 14.1%.Conclusions: TTs improve pain and function in IRCTs. LD transfers remain the most widely used. Variability in techniques and outcomes highlights the need for standardized protocols and further high-quality research.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251368884"},"PeriodicalIF":1.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875621","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}

引用次数: 0

Nonarthroplasty surgical management of massive irreparable posterosuperior rotator cuff tears: A systematic review and meta-analysis. 大量不可修复的后上肩袖撕裂的非关节成形术治疗：系统回顾和荟萃分析。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-13 DOI: 10.1177/17585732251366840

Rafael Fernando Serrano-Sánchez, Arnovis Colina Ortega, Ana Marcela Piña Quintero, Luis F Giraldo-Cadavid

{"title":"Nonarthroplasty surgical management of massive irreparable posterosuperior rotator cuff tears: A systematic review and meta-analysis.","authors":"Rafael Fernando Serrano-Sánchez, Arnovis Colina Ortega, Ana Marcela Piña Quintero, Luis F Giraldo-Cadavid","doi":"10.1177/17585732251366840","DOIUrl":"10.1177/17585732251366840","url":null,"abstract":"Introduction: Massive irreparable posterosuperior rotator cuff tears (MRCTs) pose clinical and surgical challenges due to tendon retraction, fatty infiltration, muscle atrophy, and poor tissue quality. Nonarthroplasty options have emerged as alternatives to shoulder arthroplasty.Methods: We conducted a systematic review and meta-analysis of comparative studies evaluating nonarthroplasty surgical treatments for MRCTs. We searched PubMed, LILACS, Scopus, and Google Scholar, including studies with at least 12 months of follow up. Functional outcomes, range of motion, and complication rates were extracted. Risk of bias was assessed using ROBINS-I.Results: Twenty-one studies (n = 1036 patients) were included, evaluating partial repair, tendon transfers, superior capsular reconstruction (SCR), debridement, augmentation, and subacromial balloon spacers. All techniques showed functional improvement and pain reduction. Partial repair showed better external rotation than augmentation. Tendon transfers and SCR yielded similar functional outcomes. Augmentations had the highest complication rate (33%), while debridement the lowest (10%). These findings may reflect differences in baseline pathology severity and the relative complexity of the surgical techniques.Conclusion: Nonarthroplasty surgical options for MRCTs provide significant functional gains and pain relief. No technique demonstrated clear superiority. Overall evidence quality was low, highlighting the need for future high-quality comparative studies to optimize treatment strategies.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251366840"},"PeriodicalIF":1.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875622","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}

引用次数: 0

Body mass index greater than 40 does not portend worse outcomes for patients undergoing shoulder arthroplasty. 体重指数大于40并不预示接受肩关节置换术的患者预后更差。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-12 DOI: 10.1177/17585732251368811

James A Rhead, Noah Dinapoli, Ani Fares, Frank Dy, Edward C Beck, Nicholas A Trasolini, Benjamin Graves, Brian R Waterman, Alan W Reynolds

{"title":"Body mass index greater than 40 does not portend worse outcomes for patients undergoing shoulder arthroplasty.","authors":"James A Rhead, Noah Dinapoli, Ani Fares, Frank Dy, Edward C Beck, Nicholas A Trasolini, Benjamin Graves, Brian R Waterman, Alan W Reynolds","doi":"10.1177/17585732251368811","DOIUrl":"10.1177/17585732251368811","url":null,"abstract":"Background: Conflicting data exists surrounding the impact of body mass index (BMI) on total shoulder arthroplasty (TSA) outcomes.Methods: This retrospective study reviewed patients undergoing primary anatomic and reverse TSA with ≥2-year follow-up and completed patient-reported outcome measures (PROMs), including American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and Visual Analog Scale. PROMs and range of motion (ROM) were analyzed based on BMI and other metabolic factors, including hemoglobin A1C, albumin, low-density lipoprotein, total cholesterol, and vitamin D.Results: A total of 217 patients were included, with an average follow-up of 34 months. No differences were found in ROM or PROMs at final follow-up, based on categorical BMIs of <30, 30-40, and >40 kg/m2. However, BMI > 40 was associated with greater improvements in ASES (P = 0.018) and SANE (P = 0.028) scores. Achievement of ASES minimal clinically important difference was also higher in patients with a higher BMI as a continuous variable (P = 0.019), likely due to lower pre-operative scores. Other metabolic factors were not independently associated with final PROMs.Conclusion: Obesity, including BMI > 40 kg/m2, does not negatively impact perceived and functional improvement following TSA.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251368811"},"PeriodicalIF":1.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856644","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}

引用次数: 0

Long-term mortality rates in patients with proximal humerus fracture managed acutely with reverse shoulder arthroplasty and hemiarthroplasty. 肱骨近端骨折患者采用反向肩关节置换术和半肩关节置换术治疗的长期死亡率。

IF 1.1

Shoulder and Elbow Pub Date : 2025-08-12 DOI: 10.1177/17585732251359475

Yushy Zhou, Samuel J Lynskey, Peiyao Du, David Rj Gill, Sophie Corfield, Marc Hirner, Brett Moreira

{"title":"Long-term mortality rates in patients with proximal humerus fracture managed acutely with reverse shoulder arthroplasty and hemiarthroplasty.","authors":"Yushy Zhou, Samuel J Lynskey, Peiyao Du, David Rj Gill, Sophie Corfield, Marc Hirner, Brett Moreira","doi":"10.1177/17585732251359475","DOIUrl":"10.1177/17585732251359475","url":null,"abstract":"Background: Proximal humerus fractures (PHFs) are common in the elderly, often requiring acute arthroplasty, such as reverse shoulder arthroplasty (RSA) or hemiarthroplasty (HA). Understanding long-term mortality trends in these patients is crucial for improving care and informing health economic analyses.Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry (2004-2022) were analysed. Patients who underwent primary RSA or HA for PHF were included. Mortality rates were calculated using standardised mortality ratios (SMRs) and compared to the general Australian population, with subgroup analyses based on age, gender, body mass index (BMI), and American Society of Anaesthesiologists (ASA) score.Results: A total of 7868 RSA and 3006 HA procedures were reviewed. PHF patients undergoing RSA or HA had significantly higher mortality rates than the general population, with an increasing trend over 15 years. Higher mortality was associated with younger age, male gender, extreme BMI, and higher ASA scores.Conclusion: PHF patients receiving acute arthroplasty face higher long-term mortality, influenced by demographic and clinical factors. These findings underscore the need for optimised care and healthcare policy adjustments for this vulnerable group. Further research is required to establish causality and improve outcomes.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251359475"},"PeriodicalIF":1.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856645","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}

引用次数: 0