Shoulder and Elbow最新文献

{"title":"A comparative analysis of a central metaphyseal humeral fixation stemless shoulder arthroplasty to an anatomic shoulder arthroplasty in a national registry cohort.","authors":"Dane C Peckston, Elliott D'Costa, David Rj Gill, Dylan Harries, Richard Page, Mohammed Baba","doi":"10.1177/17585732241307245","DOIUrl":"10.1177/17585732241307245","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the revision outcome between a centrally fixed stemless anatomic design and other total anatomic shoulder replacements using data from a large national arthroplasty registry.</p><p><strong>Methods: </strong>The study period was from December 2011 to December 2022 and included three cohorts; primary Affinis stemless anatomic (AFS), all other primary total stemless anatomic (sTSA) and primary total stemmed anatomic shoulder arthroplasty (aTSA). The endpoint was all-cause revision using cumulative percent revision (CPR). Hazard ratio (HR) models were adjusted for age and gender.</p><p><strong>Results: </strong>There were 2489 primary AFS, 1593 primary sTSA and 11,023 primary aTSA. There was no difference in revision rates between the AFS and the sTSA group. The aTSA group had a significantly higher rate of revision compared to both AFS (HR = 1.63, 95% confidence interval (CI) 1.30-2.05, <i>p</i> < 0.001) and sTSA (HR = 1.61, 95% CI 1.21-2.15, <i>p</i> = 0.001). However, sub-analyses stratifying for highly crosslinked polyethylene (XLPE) showed no differences between the groups.</p><p><strong>Discussion: </strong>The rates of revision between the AFS design and other stemless prostheses were similar. Stemless had lower revision rates to aTSA. When only considering XLPE cemented glenoids, there was no significant difference in revision rates.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241307245"},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898798","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":"What volume of injection should be used in hydrodilatation for frozen shoulder? A prospective cohort study.","authors":"Jasmeet Jhaj, Benjamin Woolner, Sally Rankin, Gabriel Heard, Andrew Planner, Hyeladzira Thahal, David Woods","doi":"10.1177/17585732241307860","DOIUrl":"10.1177/17585732241307860","url":null,"abstract":"<p><p>This study evaluated the outcome and recurrence rates after hydrodilatation (HD) in patients with frozen shoulder (FS), comparing the effects of injecting 25 mL or more of fluid versus lower volumes. A total of 132 shoulders (130 patients) were treated at a shoulder clinic between August 2019 and February 2023. HD was performed under ultrasound guidance, injecting a combination of 40 mg Triamcinolone, 10 mL of local anaesthetic, and saline to a total volume of 10 to 40 mL based on patient tolerance. The results were analysed based on the volume of fluid injected and whether patients were diabetic. The overall failure or recurrence rate (FRR) was 24% after a minimum of 1 year. Non-diabetic patients injected with ≥25 mL had a significantly lower FRR (9%) compared to those injected with <25 mL (30%, <i>p</i> = 0.006). Diabetic patients had a much higher FRR of 52%, compared to 17% in non-diabetics (<i>p</i> = 0.0002). The study concluded that injecting patients with ≥25 mL of fluid had a significantly lower FRR than those injected with <25 mL at a minimum of 12 months follow-up (9% vs 30%, <i>p</i> = 0.006). Diabetic patients experienced a higher rate of recurrence, suggesting the need for patient counselling about the increased likelihood of failure.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241307860"},"PeriodicalIF":1.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878226","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":"Impact of elbow stiffness on running economy in trained athletes.","authors":"Cecilia Wilk, Cyril Besson, Laurie Stockton, Frédéric Vauclair, Vincent Gremeaux","doi":"10.1177/17585732241306369","DOIUrl":"10.1177/17585732241306369","url":null,"abstract":"<p><strong>Background: </strong>Elbow injuries are likely to generate a decreased range of motion (ROM), which might negatively affect athletic performance. To date, the effect of elbow stiffness on endurance running performance has never been studied. We conducted an observational, prospective, cross-over study to examine the impact of elbow stiffness on running economy.</p><p><strong>Methods: </strong>Twenty trained athletes performed running economy tests at 12 km·h^-1, with and without a limited elbow ROM (flexion: 90°, extension: 45°), imposed by a dynamic brace mimicking a severe elbow stiffness. Relative intensity and performance indexes were measured during a subsequent maximal incremental exercise test.</p><p><strong>Results: </strong>Running economy was measured at 180 ± 10.6 mlO₂·km^-1·kg^-1 with a full ROM, and 180.2 ± 12.3 mlO₂·km^-1·kg^-1 with the limited ROM showing a non-significant 0.1% difference (<i>p</i> = 0.871).</p><p><strong>Discussion: </strong>Athletes experiencing post-traumatic elbow stiffness can find reassurance in knowing that it does not seem to impact a crucial metric of endurance running performance, namely running economy. Further research could explore elbow movement at different intensities of running, from higher aerobic speeds to sprinting.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241306369"},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878172","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":"Severe malnutrition predicts early postoperative complications in aseptic revision total shoulder arthroplasty.","authors":"Steven H Liu, Rustin Mahboubi Ardakani, Rachel A Loyst, Patricia Cerri-Droz, David E Komatsu, Edward D Wang","doi":"10.1177/17585732241306303","DOIUrl":"10.1177/17585732241306303","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the association between the Geriatric Nutritional Risk Index (GNRI), a simple readily available measure of malnutrition risk, and 30-day postoperative complications following revision total shoulder arthroplasty (TSA).</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent TSA between 2015 and 2022. The study population was divided into three groups based on preoperative GNRI: normal/reference (GNRI > 98), moderate malnutrition (92 ≤ GNRI ≤ 98), and severe malnutrition (GNRI < 92). Logistic regression analysis was conducted to investigate the connection between preoperative GNRI and postoperative complications.</p><p><strong>Results: </strong>Compared to normal nutrition, moderate malnutrition was not independently associated with postoperative complications. Compared to normal nutrition, severe malnutrition was independently associated with a greater likelihood of experiencing any complication (odds ratio (OR) 3.08, 95% confidence interval (CI) 1.80-5.27; <i>P </i>< 0.001), blood transfusions (OR 3.68, 95% CI 1.40-9.66; <i>P </i>= 0.008), non-home discharge (OR 2.99, 95% CI 1.50-5.98; <i>P </i>= 0.002), and length of stay >2 days (OR 3.10, 95% CI 1.77-5.42; <i>P </i>< 0.001).</p><p><strong>Discussion: </strong>Severe malnutrition based on GNRI is a predictor of early complications following revision TSA, however moderate malnutrition is not.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241306303"},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878192","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":"The effect of rotator cuff repair on sleep quality: Influencing factors and the impact of narcotic medication on postoperative sleep patterns: A systematic review and meta-analysis.","authors":"Adam Daniel Mozes, Richard M Danilkowicz, Loren Stephany Haichin, Felipe Gonzalez, Tzadok Yona, Dror Lindner, Yiftah Beer, Grant E Garrigues, Ron Gilat","doi":"10.1177/17585732241298247","DOIUrl":"10.1177/17585732241298247","url":null,"abstract":"<p><strong>Background: </strong>Impaired sleep quality often drives patients with rotator cuff tears (RCT) to seek surgical intervention. This meta-analysis reviews the impact of arthroscopic rotator cuff repair (ARCR) on sleep quality beyond six months and identifies influencing factors, primarily narcotics, on sleep quality.</p><p><strong>Methods: </strong>The search spanned PubMed, Google Scholar, Embase, and the Cochrane Central Register, targeting articles evaluating rotator cuff injury and sleep quality. Information gathered included study features, bias risk assessment, evaluation of sleep quality using sleep-specific patient-reported outcomes, and the effects of opiates on sleep outcomes.</p><p><strong>Results: </strong>Ten studies, including 445 patients who underwent ARCR were included. The preoperative mean Pittsburgh Sleep Quality Index (PSQI) varied from 6.6 to 15. Eight studies presented a mean PSQI score of 3.6-7.1 at 6 months postoperatively; two studies reported mean score of 4.2 and 5.4 at 12 months. Both were found to be statistically significant by this meta-analysis compared to preoperative scores. Three studies found narcotic use, RCT size, alcohol consumption, diabetes, and hypertension to negatively affect PSQI scores.</p><p><strong>Discussion: </strong>Arthroscopic rotator cuff repair significantly improves sleep quality at 6 and 12 months following surgery. Perioperative narcotic use, RCT size, alcohol consumption, diabetes, and hypertension may negatively impact sleep quality.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241298247"},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878219","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":"Cirrhosis associated with increased complications and healthcare utilization following total shoulder arthroplasty.","authors":"John A Martino, Alexander S Guareschi, Brandon L Rogalski, Josef K Eichinger, Richard J Friedman","doi":"10.1177/17585732241306098","DOIUrl":"10.1177/17585732241306098","url":null,"abstract":"<p><strong>Introduction: </strong>Cirrhosis is a known risk factor for morbidity and mortality following surgical procedures and has been associated with increased complications, hospital length of stay (LOS), and cost of admission following total joint arthroplasty. However, a paucity of literature exists evaluating the effect of cirrhosis on postoperative outcomes following total shoulder arthroplasty (TSA). The purpose of this study is to evaluate the short-term outcomes following elective primary TSA in patients with cirrhosis compared to matched controls.</p><p><strong>Methods: </strong>The Nationwide Readmissions Database was queried from 2016 to 2020 to identify patients who underwent elective primary TSA. Patients with a diagnosis of cirrhosis (<i>n</i> = 627) were matched in a 1:1 proportion to patients who did not have cirrhosis. Bivariate statistical analyses were performed to compare preoperative demographic and comorbidity data, postoperative outcomes, and hospital utilization metrics between the two groups. Following Bonferroni correction, an alpha value of 0.003 defined significance.</p><p><strong>Results: </strong>Patients with cirrhosis exhibited higher rates of postoperative medical and implant-related complications following primary TSA, including acute renal failure (6.3% vs 1.1%: <i>p</i> < 0.001), urinary tract infection (3.5% vs 0.6%; <i>p</i> < 0.001), transfusions (3.0% vs 0.2%; <i>p</i> < 0.001), acute respiratory distress syndrome (2.9% vs 0.2%: <i>p</i> = 0.002), surgical site infection (2.0% vs 0.2%: <i>p</i> = 0.001), dislocation (2.1% vs 0.0%: <i>p</i> < 0.001), and prosthetic loosening (1.5% vs 0.0%; <i>p</i> = 0.002). These patients also exhibited higher rates of all-cause complications (32% vs 9.2%: <i>p</i> < 0.001) and mortality (1.5% vs 0.0%; <i>p</i> = 0.002) within 180 days of surgery and had an increased cost of admission ($24,633 vs $18,500; <i>p</i> < 0.001) and LOS (2.6 vs 1.5 days; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Patients with cirrhosis were found to have increased risk of medical and surgical complications, higher costs, and longer LOS following TSA. These findings can assist orthopedic surgeons in developing strategies in the preoperative period to mitigate complications in this at-risk patient group.</p><p><strong>Level of evidence: </strong>Level III - Retrospective cohort study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241306098"},"PeriodicalIF":1.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865732","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":"Revision radiocapitellar arthroplasty by mismatched implant components - A salvage option: A report of two cases with a minimum three-year follow-up.","authors":"Tiago Martinho, Pieter Caekebeke, Lotte Verstuyft, Roger van Riet","doi":"10.1177/17585732241297152","DOIUrl":"10.1177/17585732241297152","url":null,"abstract":"<p><p>Radiocapitellar arthroplasty has been shown to improve pain and function in patients with a degenerative joint. Due to problems with the loosening of the radial head component, one of the few available systems was removed from the global market. This offered specific challenges in terms of treatment strategies when one or both components of a system that is no longer available fail. Due to the very different geometry of the capitellar implant, revision of the capitellar component would require a complex procedure, likely requiring bone graft and a high chance of early failure, leaving resection or interposition arthroplasty as the only available option. Although implant mismatch is common practice in hip and knee arthroplasty with satisfactory results, it should remain a salvage option as the off-label use of components gives rise to several medicolegal implications. We report two cases of radiocapitellar arthroplasty partial revision, by replacing only the radial head component with an implant from another system while keeping the well-fixed original capitellar component in place. At a minimum of three-year follow-up, both cases improved from poor to good and excellent Mayo elbow performance scores. There were no signs of implant failure on standard radiographs.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241297152"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814418","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":"Does long-term surveillance of primary linked total elbow arthroplasty identify failing implants requiring revision?","authors":"Daniel Leslie James Morris, Avneet Minhas, Katherine Walstow, Lisa Pitt, Marie Morgan, Tim Cresswell, Marius P Espag, David I Clark, Amol A Tambe","doi":"10.1177/17585732241301356","DOIUrl":"10.1177/17585732241301356","url":null,"abstract":"<p><strong>Background: </strong>Scoping review has identified a lack of evidence guiding long-term follow-up of elbow arthroplasty. We report the effectiveness of primary linked total elbow arthroplasty surveillance in identifying failing implants requiring revision.</p><p><strong>Methods: </strong>A prospective database recording consecutive primary linked total elbow arthroplasty and subsequent surveillance in an elbow unit was analysed. Arthroplasties performed between 01.10.2013 and 31.07.2022 were included, with a minimum 1-year follow-up. Surveillance involves specialist physiotherapist review 1, 2, 3, 5, 8 and 10 years postoperatively. Patient-initiated review could occur between time points. Outcome measures include a number of surveillance reviews offered and attended; and the proportion that identified a failing implant requiring revision.</p><p><strong>Results: </strong>Ninety-seven primary linked total elbow arthroplasties with minimum 1-year follow-up were performed (76 Discovery, 14 Nexel, 7 Coonrad/Morrey). Sixteen patients died prior to 31.07.2023, and three implants required revision <1 year postoperatively. 290 of 328 offered surveillance appointments were attended (88.4%). Five implants required revision ≥1 year post-operatively, with revision requirements identified by surveillance in all cases. Three failures occurred at 5 years postoperatively, and two failures occurred at 8 years postoperatively. Overall, 1.7% attended surveillance appointments identified a failing implant requiring revision.</p><p><strong>Discussion: </strong>This is the first series reporting the effectiveness of primary linked total elbow arthroplasty surveillance in identifying implants requiring revision.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241301356"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814413","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":"Racial and ethnic disparities in short-stay primary total shoulder arthroplasty.","authors":"Vivek N Pandey, Sarah K Thomas, John W Moore, Alexander S Guareschi, Brandon L Rogalski, Josef K Eichinger, Richard J Friedman","doi":"10.1177/17585732241303097","DOIUrl":"10.1177/17585732241303097","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of literature evaluating the utilization of short-stay total shoulder arthroplasty (TSA) in different racial groups. The purpose of this study is to compare short-stay TSA utilization and postoperative outcomes across racial groups.</p><p><strong>Methods: </strong>The National Surgical Quality Improvement Program (NSQIP) database was queried from 2010 to 2018 to identify patients who underwent primary short-stay TSA, defined as a length of stay of less than 2 midnights. Annual proportions of short-stay TSA, demographic variables, preoperative comorbidities, and postoperative complications were compared across groups.</p><p><strong>Results: </strong>All racial groups showed increases in the proportion of short-stay TSA cases over time, but this increase was most evident in Whites. Hispanics had increased rates of pneumonia (0.8% vs. 0.2%; <i>p</i> = 0.002) and transfusion (2.0% vs 1.0%; <i>p</i> = 0.015) compared to Whites, but no other differences in outcomes were observed between groups.</p><p><strong>Discussion: </strong>Postoperative outcomes were similar across groups despite differing comorbidity profiles, suggesting that short-stay TSA is being implemented appropriately based on perceived preoperative risk. However, differences in utilization across groups suggest that underlying disparities may exist. Given the continued increase in short-stay TSA procedures, opportunities to resolve racial disparities are essential in mitigating the effects of social determinants of health in minority patient groups.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241303097"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796187","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":"Editorial - Michael Thomas.","authors":"Michael Thomas","doi":"10.1177/17585732241302893","DOIUrl":"https://doi.org/10.1177/17585732241302893","url":null,"abstract":"","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241302893"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796183","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}