Shoulder and Elbow最新文献_第5页

Does long-term surveillance of primary linked total elbow arthroplasty identify failing implants requiring revision? 初次联合全肘关节置换术的长期监测能否确定需要翻修的失败植入物？

IF 1.5

Shoulder and Elbow Pub Date : 2024-12-10 DOI: 10.1177/17585732241301356

Daniel Leslie James Morris, Avneet Minhas, Katherine Walstow, Lisa Pitt, Marie Morgan, Tim Cresswell, Marius P Espag, David I Clark, Amol A Tambe

{"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":"Background: 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.Methods: 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.Results: 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.Discussion: This is the first series reporting the effectiveness of primary linked total elbow arthroplasty surveillance in identifying implants requiring revision.","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}

引用次数: 0

Racial and ethnic disparities in short-stay primary total shoulder arthroplasty. 短期初级全肩关节置换术中的种族和民族差异。

IF 1.5

Shoulder and Elbow Pub Date : 2024-12-05 DOI: 10.1177/17585732241303097

Vivek N Pandey, Sarah K Thomas, John W Moore, Alexander S Guareschi, Brandon L Rogalski, Josef K Eichinger, Richard J Friedman

{"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":"Background: 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.Methods: 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.Results: 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%; p = 0.002) and transfusion (2.0% vs 1.0%; p = 0.015) compared to Whites, but no other differences in outcomes were observed between groups.Discussion: 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.","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}

引用次数: 0

Editorial - Michael Thomas. 社论-迈克尔·托马斯。

IF 1.5

Shoulder and Elbow Pub Date : 2024-12-05 DOI: 10.1177/17585732241302893

Michael Thomas

引用次数: 0

Evaluation of the accuracy and interobserver agreement of the reverse shoulder angle in the preoperative planning of reverse total shoulder arthroplasties. 评估反向全肩关节置换术术前规划中反向肩关节角度的准确性和观察者间的一致性。

IF 1.5

Shoulder and Elbow Pub Date : 2024-11-26 DOI: 10.1177/17585732241300686

Geraldo Motta, Marcus Vinícius Amaral, Márcio Cohen, Marcio Schiefer, Raphael Soares da Fonseca, Ana Carolina Leal Carolina Oliveira

{"title":"Evaluation of the accuracy and interobserver agreement of the reverse shoulder angle in the preoperative planning of reverse total shoulder arthroplasties.","authors":"Geraldo Motta, Marcus Vinícius Amaral, Márcio Cohen, Marcio Schiefer, Raphael Soares da Fonseca, Ana Carolina Leal Carolina Oliveira","doi":"10.1177/17585732241300686","DOIUrl":"10.1177/17585732241300686","url":null,"abstract":"Background: Differences in implant positioning between anatomical and reverse shoulder arthroplasties have raised concerns about the adequacy of assessing the global glenoid inclination (GGI) using the method described by Maurer to define the position of the metallic base in reverse shoulder arthroplasty. The reverse shoulder angle (RSA) has been proposed to measure the inclination of the lower half of the glenoid. This study aims to evaluate the interobserver agreement of manual measurements of the RSA using two-dimensional (2D) computed tomography (CT) images and its relationship with the automated measurement of the GGI.Methods: This cross-sectional study evaluated 2D CT images of 38 CT scans of patients with degenerative shoulder diseases. Manual measurements of the RSA were conducted by five independent shoulder surgeons. GGI measured by automated software was determined.Results: The interclass correlation coefficient was 0.72 for RSA. Mean RSA was 25.7° ± 7.1°, significantly higher than automated GGI measurements (11.2 ± 9.0; p < .0001). On average, RSA was 14.6 ± 6.3 greater than GGI, irrespective, diagnosis, Favard's glenoid subtype, and version angle.Conclusion: Our study demonstrated that the RSA angle can be reproducibly used to assess glenoid inclination on 2D CT images presenting high interobserver agreement. RSA differs significantly from the GGI, indicating that measuring glenoid inclination for reverse or anatomical arthroplasty requires distinct methodologies that account for the inherent differences in these angles.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241300686"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751906","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

Racial disparities in early postoperative proximal humerus fracture outcomes: Do minorities face longer operative times, extended hospital stays, and higher risks? 肱骨近端骨折术后早期疗效的种族差异：少数民族是否面临更长的手术时间、更长的住院时间和更高的风险？

IF 1.5

Shoulder and Elbow Pub Date : 2024-11-22 DOI: 10.1177/17585732241299052

Arman Kishan, Alexander R Zhu, Stanley Zhu, Gyeongtae S Moon, Ansh Kishan, Sukrit J Suresh, Matthew J Best, Umasuthan Srikumaran

{"title":"Racial disparities in early postoperative proximal humerus fracture outcomes: Do minorities face longer operative times, extended hospital stays, and higher risks?","authors":"Arman Kishan, Alexander R Zhu, Stanley Zhu, Gyeongtae S Moon, Ansh Kishan, Sukrit J Suresh, Matthew J Best, Umasuthan Srikumaran","doi":"10.1177/17585732241299052","DOIUrl":"10.1177/17585732241299052","url":null,"abstract":"Background: Racial disparities in orthopedic surgery outcomes have been extensively documented, highlighting systemic biases in care. Proximal humerus fractures (PHFs), about 6% of all fractures, are rising, especially among the elderly. Despite the prevalence of PHFs, a research gap exists regarding racial disparities in postoperative complications and outcomes.Methods: Data from the American College of Surgeons NSQIP database from 2006 to 2021 were analyzed, including 41,285 patients with PHFs. CPT and ICD codes guided inclusion and exclusion criteria. Propensity-score matching balanced a cohort of 17,052 patients. Demographic variables, comorbidities, and outcomes were analyzed using univariate statistics, chi-square tests, and Fisher's exact tests.Results: Post propensity-score matching, significant demographic disparities emerged between white and minority patients. Minority patients had longer operative times (p < .001) and hospital stays (p = .001) than white patients. Minority patients also exhibited higher rates of mortality (p = .04) and unplanned re-intubation (p = .04).Conclusion: This study revealed significant racial disparities in early postoperative outcomes for PHFs. Despite surgical advancements, minorities have prolonged operative times, extended hospital stays, and heightened risks of adverse events. Action is needed to ensure healthcare equity and justice and to address disparities in PHF surgical management across diverse demographics.Level of evidence: III.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241299052"},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711022","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

Abstracts for the 36th Annual Scientific Meeting BESS 2024. 第 36 届科学年会 BESS 2024 摘要。

IF 1.5

Shoulder and Elbow Pub Date : 2024-11-22 DOI: 10.1177/17585732241291698

引用次数: 0

Minimum two-year follow-up of a reverse total shoulder arthroplasty using a wedged baseplate. 使用楔形基板的反向全肩关节置换术的最短两年随访。

IF 1.5

Shoulder and Elbow Pub Date : 2024-11-21 DOI: 10.1177/17585732241293396

Simon J M Parker, Simon N Bell, Féoline Wiemer, Jennifer A Coghlan, Harry D Clitherow, Helen M Rayment

{"title":"Minimum two-year follow-up of a reverse total shoulder arthroplasty using a wedged baseplate.","authors":"Simon J M Parker, Simon N Bell, Féoline Wiemer, Jennifer A Coghlan, Harry D Clitherow, Helen M Rayment","doi":"10.1177/17585732241293396","DOIUrl":"10.1177/17585732241293396","url":null,"abstract":"Background: Avoiding inclination of the glenoid baseplate in reverse shoulder arthroplasty often requires considerable glenoid reaming. It is proposed that the use of a metal wedged baseplate in all patients can achieve neutral inclination with reduced glenoid reaming.Materials and methods: A prospective clinical single-centre study with minimum two-year follow-up was carried out. Glenoid deformity was classified on CT and surgery planned using BluePrintTM. The Tornier Perform® Reversed Wedged Augmented Glenoid was used in all cases. Clinical outcome scores and radiographs were assessed.Results: Seventy-three patients, mean age 76.6 years. Twenty-eight demonstrated no glenoid deformity and 19 demonstrated marked retroversion. Seventy completed two-year follow-up. Mean pain scores fell from 6 to 0.7. All Patient Reported Outcome Meaures (PROMS) were significantly improved. Active elevation increased by 62° and external rotation by 28.7° (p < 0.001). In patients with no glenoid wear (E0/A1), correction of inferior inclination was achievable with a 15° full-wedge baseplate in all cases, reducing the reaming depth by 4.4 mm (p < 0.001). In patients with severe glenoid wear, a 35° half wedge baseplate was often necessary to correct the deformity. The most common complications were stress reactions/fractures.Conclusion: A metal wedged baseplate can achieve neutral inclination in all patients, minimising bone reaming and preserving lateralisation with good two-year outcomes.Level of evidence: IV (case series with no comparison group).","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241293396"},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711015","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

Arthroscopic evaluation for posterolateral rotatory instability of the elbow. 肘关节后外侧旋转不稳定的关节镜评估。

IF 1.5

Shoulder and Elbow Pub Date : 2024-11-14 DOI: 10.1177/17585732241293326

Riikka Koso, Anthony Logli, Asher Mirvish, Mark Baratz

{"title":"Arthroscopic evaluation for posterolateral rotatory instability of the elbow.","authors":"Riikka Koso, Anthony Logli, Asher Mirvish, Mark Baratz","doi":"10.1177/17585732241293326","DOIUrl":"10.1177/17585732241293326","url":null,"abstract":"Objective: The purpose of this study was to evaluate the sensitivity of three arthroscopic techniques for intraoperative assessment of posterolateral rotatory instability (PLRI).Methods: The study was performed using six fresh frozen cadaveric upper extremities. The three arthroscopic tests were the modified ulnohumeral drive through test, the annular drive through test, and proximal radioulnar joint instrumentation. Sequential soft tissue sectioning was performed to create four stages of instability: baseline, transection of the anterior half of the lateral collateral ligament complex (i.e., the radial collateral ligament), transection of the posterior half of the LCL complex (i.e., the lateral ulnar collateral ligament), and finally the release of the common extensor origin. Each test was repeated with the elbow at 90-degrees flexion in neutral rotation and at 45-degrees extension in full supination.Results: Each test appropriately identified loss of the lateral ulnar collateral ligament. The modified ulnohumeral drive through test and the annular drive through test were most sensitive for loss of the radial collateral ligament. Elbow position did not affect test sensitivity.Conclusions: Each of the tests identified PLRI with high sensitivity, regardless of elbow position. The ulnohumeral and annular ligament drive through tests were more sensitive for radial collateral ligament disruption.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241293326"},"PeriodicalIF":1.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648950","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

Survivorship and outcomes of arthroscopic bankart repair for anterior shoulder dislocations: A minimum of 2 year follow-up. 肩关节前脱位的关节镜卍解修复术的存活率和疗效：至少两年的随访。

IF 1.5

Shoulder and Elbow Pub Date : 2024-11-13 DOI: 10.1177/17585732241280247

Kia Teng Lim, Wei Ping Marcus Tan, Andrew Hwee Chye Tan

{"title":"Survivorship and outcomes of arthroscopic bankart repair for anterior shoulder dislocations: A minimum of 2 year follow-up.","authors":"Kia Teng Lim, Wei Ping Marcus Tan, Andrew Hwee Chye Tan","doi":"10.1177/17585732241280247","DOIUrl":"10.1177/17585732241280247","url":null,"abstract":"Background: This study aims to evaluate long-term survivorship of arthroscopic Bankart repair (ABR).Methods: About 101 patients under a single surgeon were followed up for ≥2 years post-ABR. Primary outcome was survivorship, defined as re-dislocation post-surgery. Secondary outcomes included a range of motion, strength, pain, University of California-Los-Angeles shoulder score, Oxford shoulder score (OSS), Oxford Shoulder Instability Score (OSIS), Constant Murley Score, and satisfaction. Clinical factors were correlated.Results: Eight patients experienced postoperative dislocation (5 high-energy trauma, 2 low-energy trauma, 1 atraumatic), with 2 patients requiring revision. The mean time to post-operative dislocation was 1.5 years (range 0.3-3.8). Competitive athletes demonstrated worse survivorship (p = 0.027) but greater isometric strength at 6 months (p = 0.041) compared to recreational players. Patients ≥25 years old experienced slower recovery of internal rotation at 3 months (p = 0.006). Patients with surgery >1 year after injury had slower recovery of external rotation (p = 0.006), worse Constant scores at 3 months (p = 0.036) and lesser improvements in isometric strength at 3 months (p = 0.032). Patients with single pre-operative dislocations (p = 0.036 OSS; p = 0.039 OSIS) and patients ≥25 years old (p = 0.044 OSS) had worse Oxford scores at 3 months.Discussion: ABR demonstrates good outcomes with low recurrence. This study prognosticates long-term outcomes across various subgroups.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241280247"},"PeriodicalIF":1.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649048","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

Re-tear following rotator cuff repair: Do functional outcomes predict success? 肩袖修复术后再次撕裂：功能结果是否预示着成功？

IF 1.5

Shoulder and Elbow Pub Date : 2024-11-06 DOI: 10.1177/17585732241267222

Nathan Angerett, Timothy Maurer, Rex Lutz, Tia Alexander, Leighann Krasney, Matthew Kelly

{"title":"Re-tear following rotator cuff repair: Do functional outcomes predict success?","authors":"Nathan Angerett, Timothy Maurer, Rex Lutz, Tia Alexander, Leighann Krasney, Matthew Kelly","doi":"10.1177/17585732241267222","DOIUrl":"10.1177/17585732241267222","url":null,"abstract":"Purpose: The purpose of this study is to compare functional outcomes between patients who were found to have a retear on ultrasound versus those with an intact repair following arthroscopic rotator cuff repair.Methods: Retrospective cohort study comparing functional outcomes of 84 patients who underwent arthroscopic rotator cuff repair and were found to have a retear versus those who did not experience a retear. Functional outcomes included American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test, strength and active range of motion (AROM) assessed preoperatively and postoperatively at 3 and 6 months.Results: Patients without a retear by 6 months demonstrated greater improvements in internal rotation at 3 months (2.3° of mean change, p = 0.0356), as well as greater improvements in external rotation range of motion (8.8° of mean change, p = 0.0210) between 3 and 6 months as compared to those patients who did experience a retear. Both groups showed decreased pain scores and increased ASES scores at all points postoperatively.Conclusions: Our study found statistically significant improvements in internal rotation at 3 months, and external rotation between 3 and 6 months in the non-retear group. No differences in functional outcomes existed between at final follow-up.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241267222"},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629958","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