Shoulder and Elbow最新文献

{"title":"Stress shielding in reverse shoulder arthroplasty using a proximally coated stem for proximal humeral fractures: Does it have clinical relevance?","authors":"Francesc Goñalons-Giol, Cristina Ventura-Parellada, Javier Alonso-Rodríguez-Piedra, Xavier Llorens-Martínez, Ferran Gàmez-Baños, José-María Mora-Guix","doi":"10.1177/17585732241309899","DOIUrl":"https://doi.org/10.1177/17585732241309899","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical significance of stress shielding in patients who have undergone an uncemented reverse shoulder arthroplasty (RSA) with a proximally coated stem for complex proximal humeral fractures (PHF) comprising 3 or 4 parts, assessed at 2 years postoperatively. Additionally, this study aims to examine the correlation between tuberosity healing and clinical outcomes.</p><p><strong>Methods: </strong><b>Setting:</b> Single Centre.<b>Patient Selection Criteria:</b> 43 patients underwent surgery involving a cementless RSA with an anatomical stem (Mini Stem of Zimmer Biomet ^® Comprehensive System) following an acute 3- or 4-part or 4-part with luxation PHF within 4 weeks of injury. Patients who were excluded from the study included those who passed away, did not have a minimum 2-year follow-up, or had undergone cemented RSAs or alternative humeral components, as well as those who required RSA due to fracture sequelae.<b>Outcome Measures and Comparisons:</b> Stress shielding, tuberosity healing and its positioning were evaluated. Clinical-functional assessments were made using the Constant and ASES scores. Furthermore, quality of life assessments, including QuickDASH score, SF-12, satisfaction test (SANE) and Visual Analogue Scale (VAS) were performed.</p><p><strong>Results: </strong>Of the total shoulders, 6 (13.9%) were excluded, leaving 37 PHFs that met the inclusion criteria. The mean age at the time of surgery was 72 years (range, 61-85). Stress shielding was observed in 31 shoulders (83.8%). There was no observed correlation between stress shielding and clinical-functional or quality of life assessments. The greater tuberosity in patients without stress shielding was found to be above the tray (66.7%) (<i>P</i> < 0.05). Tuberosity healing was observed in 94.6% (35/37) of the shoulders.</p><p><strong>Conclusions: </strong>No significant clinical difference was observed between patients with and without stress shielding in terms of short-term functional outcomes. Successful consolidation of the tuberosities can be attained even in cases with notable stress shielding.</p><p><strong>Level of evidence: </strong>Level IV; Case Series; Treatment study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241309899"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956335","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":"Limited health literacy in shoulder and elbow patients.","authors":"Melissa A Wright, Danielle S Shapiro, Aman Chopra, Anand M Murthi","doi":"10.1177/17585732231197171","DOIUrl":"10.1177/17585732231197171","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate health literacy in orthopedic shoulder and elbow patients.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included all new English-speaking adult patients presenting to two fellowship-trained shoulder and elbow surgeons from October 2020-July 2021. Patients who did not complete the Brief Health Literacy Screen Tool (BRIEF) were excluded, leaving 594 patients. Patient demographics and patient-reported outcome scores were also collected.</p><p><strong>Results: </strong>Average BRIEF score was 18.7 (range, 4-20), with limited health literacy (BRIEF <17) in 84 patients (14.1%). Patients with limited health literacy were significantly older (58 ± 18 vs. 54 ± 15 years, p = 0.03), less likely to be employed (34 [40%] vs. 332 [65%], p < 0.001), and less likely to have private insurance (35 [42%] vs. 330 [65%], p < 0.001). Average area deprivation index percentile was significantly higher (more deprivation) with limited (38 ± 20) compared to adequate health literacy (32 ± 21; p = 0.027). PROMIS physical (40.5 ± 8.5 vs. 45.5 ± 7.6, p = 0.001) and mental health scores (46.9 ± 10.5 vs. 51.0 ± 8.6, p = 0.015) and pain visual analog scale scores (5.3 ± 2.9 vs. 4.6 ± 2.7, p = 0.017) were significantly worse with limited health literacy.</p><p><strong>Discussion: </strong>Limited health literacy is present in shoulder and elbow patients and may affect patient-reported outcomes. Surgeons must recognize this in order to provide high-level equitable care.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"194 1","pages":"36-42"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74237326","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":"Is the use of abduction pillows crucial for post-operative rehabilitation following reverse total shoulder arthroplasty?","authors":"Mark M Cullen, Eric Warren, Eoghan T Hurley, Daniel E Goltz, Samuel Lorentz, Bryan S Crook, Kwabena Adu-Kwarteng, Jay M Levin, Christopher S Klifto, Oke A Anakwenze","doi":"10.1177/17585732241309019","DOIUrl":"10.1177/17585732241309019","url":null,"abstract":"<p><strong>Background: </strong>Surgeons often use abduction pillows after reverse total shoulder arthroplasty (rTSA), but evidence for their benefits is limited. This study compares outcomes for patients using a sling with or without an abduction pillow post-operatively.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients undergoing primary rTSA. Patients were grouped based on post-operative use of an abduction pillow or not. Data was collected at 6 weeks, 3 months, 6 months, 1 year, and final follow-up. Primary outcomes included rates of post-operative dislocation, range of motion, and patient-reported outcomes.</p><p><strong>Results: </strong>Patients using an abduction pillow showed reduced forward flexion at 3 months (120° vs. 139°, p = 0.002) and 6 months (135° vs. 147°, p = 0.049). At 6 weeks, abduction was lower in the pillow group (90° vs. 124°, p = 0.01). There were no significant differences in other range-of-motion metrics or patient-reported outcomes. Using no pillow did not increase dislocation risk (OR: 1.67, p = 0.60), infection, readmission, revision, or repeat surgery rates.</p><p><strong>Conclusions: </strong>Post-operative sling use without an abduction pillow after rTSA appears safe, with no increase in complications and similar patient satisfaction and outcomes.</p><p><strong>Level of evidence: </strong>Therapeutic Level III.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241309019"},"PeriodicalIF":1.5,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915868","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 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}