Seminars in Arthroplasty最新文献

{"title":"Use of ChatGPT vs. Google web search in anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty: from a patient’s perspective","authors":"Alexander K. Hahn MD ,&nbsp;Gregory M. Connors BS ,&nbsp;Martinus Megalla MD ,&nbsp;Zachary T. Grace MD ,&nbsp;Brett J. Croen MD ,&nbsp;Michael R. Mancini MD ,&nbsp;Matthew R. LeVasseur MD ,&nbsp;Corey R. Dwyer MD ,&nbsp;Katherine J. Coyner MD, MBA","doi":"10.1053/j.sart.2024.11.005","DOIUrl":"10.1053/j.sart.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence, which encompasses machine learning and natural language processing has made strides in recent years. Among these models, ChatGPT has gained attention for its abilities to allow for interactive responses. Given the rising popularity of ChatGPT, and its ability to understand medical complexity, this study aimed to evaluate ChatGPT’s utility in answering medical questions vs. the most widely used search engine in the United States, Google. The goal of this study is to replicate a patient’s web search to assess the utility of ChatGPT vs. Google regarding the most popular questions asked by patients undergoing a total shoulder replacement and reverse total shoulder replacement.</div></div><div><h3>Methods</h3><div>A Google web search was performed with the following search terms: “total shoulder replacement” and “reverse total shoulder replacement” and the top 10 frequently asked questions (FAQs) for each term were recorded along with the source. ChatGPT was then asked for the top 10 FAQs searched for total shoulder replacement and reverse total shoulder replacement and responses recorded. A Google web search was then completed using the same search terms and the top 10 FAQs, which included a numerical response were recorded. These questions were then placed into ChatGPT. Both the Google web search and ChatGPT responses to the questions were recorded, along with the source that provided the answer.</div></div><div><h3>Results</h3><div>Eight of the 20 questions were similar when performing a Google Web search and ChatGPT for the search terms “total shoulder replacement.” Ten of the 20 questions were similar when using the search term “reverse shoulder replacement”. The most common subcategory was “evaluation of surgery” for Google (6 of 20) and “technical” for ChatGPT (5 of 20). The most common sources for answers to the top 10 FAQs for Google for both total shoulder arthroplasty and reverse total shoulder arthroplasty were academic sources (9 of 20).</div></div><div><h3>Conclusion</h3><div>Google and ChatGPT users ask similar types of questions and reveal similar answers. ChatGPT typically offers more detailed answers but is less transparent at providing its source and generates improper sources up to 47% of the time. However, for properly cited references, ChatGPT typically uses credible government or academic sources compared to Google. Since Google is currently more familiar for its users than ChatGPT, it may be easier to use for patients wanting fast, simple answers to their questions, while ChatGPT may be superior for patients who may have multiple questions that want longer answers.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 2","pages":"Pages 158-165"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of glenoid screw length between 3D planned length and standard surgical measurement in reverse shoulder arthroplasty","authors":"Mathieu Dejonghe MD ,&nbsp;Christophe De Decker MD ,&nbsp;Dirk Petré MD","doi":"10.1053/j.sart.2024.11.002","DOIUrl":"10.1053/j.sart.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Glenoid positioning and fixation have important implications for the outcome and survival of reverse shoulder arthroplasty. Therefore, we aim to assess new methods of assuring correct placement and fixation of the glenoid component. 3-dimensional (3D) planning can help correctly position the glenoid, however, reproducibility of the plan perioperatively is sometimes difficult. Adjustable, reusable, patient-adapted guides may be as useful and a lot more cost-reducing compared to printed models in patient-specific instrumentation.</div></div><div><h3>Methods</h3><div>This prospective study compared preoperatively planned screw lengths for glenoid screws and perioperatively measured screw lengths in reverse shoulder arthroplasty in 44 patients. Therefore, 3D planning to determine optimal screw length and trajectory were carried out preoperatively, while during surgery screw trajectories were measured. Statistical analysis involved analyzing the correlation between the measured screw length and the planned screw length. Our primary endpoint was to see whether preoperative 3D planning without patient-specific guides can accurately predict glenoid screw length and aid in the correct positioning and fixation of glenoid baseplates.</div></div><div><h3>Results</h3><div>Forty-four patients were included. Twenty five of the 44 superior screws (56.8%) were adequately predicted (r = 0.69 [<em>P</em> &lt; .001]). Thirty six of 44 screws (81.8%) differed by a maximum of 1 size. Twenty two of the 44 inferior screws (50%) were adequately planned (r = 0.37 [<em>P</em> = .013]). Also, 36 of 44 screws (81.8%) differed by a maximum of 1 size. In 13 cases, an anterior screw was placed of which only 3 were adequately planned (23.1%) (r = 0.62 [<em>P</em> = .025]). A posterior screw was also used in 13 cases of which 4 were the same as planned (30.7%) (r = 0.35 [<em>P</em> = .245]). Of all screws per patient, 13 received the same length of screws as preoperatively planned (29%). All implants in 26 of 44 patients (59%) were adequately predicted within a maximum difference of 1 size.</div></div><div><h3>Conclusion</h3><div>3D planning and reusable guides can aid in the correct placement of glenoid components; however, accuracy could be improved by adding rotational control to the implantation of the glenoid and taking into account the depth of ream. A large discrepancy between planned and measured screw length offers an extra control that could trigger the surgeon’s attention in case of misplacement.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 2","pages":"Pages 134-140"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early postoperative opioid consumption following liposomal bupivacaine compared to standard bupivacaine in interscalene brachial plexus block for shoulder arthroplasty","authors":"Jonathan D. Harley BA,&nbsp;Confidence Njoku Austin MD,&nbsp;Jerome C. Murray MD,&nbsp;Alicia K. Harrison MD,&nbsp;Allison J. Rao MD","doi":"10.1053/j.sart.2024.11.003","DOIUrl":"10.1053/j.sart.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>To retrospectively compare early postoperative opioid consumption in patients undergoing shoulder arthroplasty who receive an interscalene brachial plexus nerve block with either standard or liposomal bupivacaine.</div></div><div><h3>Methods</h3><div>A retrospective review was performed at a large multicenter health-care system. Patients included those who underwent primary total shoulder arthroplasty or reverse shoulder arthroplasty between January 2021 and January 2024, were aged 18-99 at the time of hospital admission, had a primary diagnosis of osteoarthritis, and received an interscalene brachial plexus nerve block using either standard bupivacaine or liposomal bupivacaine before surgery. The primary outcome was opioid usage, measured in morphine milligram equivalents (MMEs). Secondary outcomes were length of stay and readmission rate.</div></div><div><h3>Results</h3><div>A total of 870 patients were included in the study. Liposomal bupivacaine was associated with a statistically significant reduction in opioid consumption at postoperative day 0 (median: 0.0 vs. 7.5 MME, <em>P</em> &lt; .001), day 1 (0.0 vs. 15.0 MME, <em>P</em> &lt; .001), and cumulatively during admission (4.0 vs. 25.2 MME, <em>P</em> &lt; .001). Reductions in opioid consumption on postoperative day 1 and during the entire admission were judged to be clinically significant. Patients receiving liposomal bupivacaine were much more likely to receive 0 MME during their admission (relative risk: 2.84, 95% confidence interval: 2.23-3.63, <em>P</em> &lt; .001). Patients who received liposomal bupivacaine had shorter admissions compared to control (1.19 ± 0.70 days vs. 1.38 ± 1.24 days, <em>P</em> = .01). There were no differences in readmission rate (<em>P</em> = .83) or time to readmission (<em>P</em> = .73) between groups.</div></div><div><h3>Conclusion</h3><div>Liposomal bupivacaine delivered via interscalene brachial plexus block was shown to significantly reduce immediate postoperative opioid consumption and length of stay compared to standard bupivacaine before shoulder arthroplasty. Furthermore, patients receiving liposomal bupivacaine were more likely to be opioid-free during their surgical admission.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 2","pages":"Pages 141-146"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of reverse total shoulder arthroplasty in patients aged under 60 vs. over 60 years","authors":"Louis W. Barry BS,&nbsp;Erryk S. Katayama BA,&nbsp;Nicholas Pappa MD,&nbsp;John S. Barnett BS,&nbsp;Akshar V. Patel BS,&nbsp;Ryan C. Rauck MD,&nbsp;Julie Y. Bishop MD,&nbsp;Gregory L. Cvetanovich MD","doi":"10.1053/j.sart.2024.11.001","DOIUrl":"10.1053/j.sart.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Each year, the incidence of reverse total shoulder arthroplasty (RSA) rises. Although RSA yields positive outcomes in older patients, such as improved range of motion (ROM) and reduced pain with rare occurrences of revision surgery, its application in patients under 60 years of age introduces distinct challenges. As RSA becomes increasingly common in younger patients, it is essential to compare outcomes to an older cohort to balance the advantages of early intervention against potential complications and the long-term durability of implants.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on a total of 220 patients who underwent primary RSA with a minimum of 2 years of clinical follow-up. The procedures were performed by 7 surgeons at a single institution. These patients were divided into 2 groups: under and over 60 years of age. Demographic and baseline variables were extracted from electronic medical records. Preoperative and postoperative outcomes of ROM and strength were recorded. Patient-reported outcomes were obtained via phone call.</div></div><div><h3>Results</h3><div>The under-60 group included 50 patients (mean age 56.9 ± 4.6 years) with a mean follow-up of 4.9 ± 2.7 years. The over-60 group included 170 patients (mean age 71.2 ± 6.0 years) with a mean follow-up of 4.5 ± 2.1 years. When compared, the under-60 group had significantly higher postoperative external rotation ROM (&lt;60: 44° ± 25° vs. &gt;60: 39^° ± 12^°, <em>P</em> = .048) and internal rotation ROM (&lt;60: sacrum vs. &gt;60: L5, <em>P</em> = .035). Of the 50 patients in the under-60 cohort, 6 had complications (12.0%), all resulting in revision at an average of 1.7 years after primary RSA. In the over-60 group, 11 patients had 11 complications (6.5%), with 6 undergoing revision surgery. The under-60 cohort had a significantly lower implant survival rate, with a rate of 94.0% at 2 years, 85.9% at 5 years, and 85.8% at 10 years compared with 97.6% at 2 years, 96.7% at 5 years, and 94.9% at 10 years in the over-60 cohort (<em>P</em> = .021).</div></div><div><h3>Conclusion</h3><div>RSA is safe and effective for patients who are 60 years and younger compared with older patients, although the complication rate is nearly 2 times higher in the younger cohort. An early intervention yields important considerations: younger individuals often have heightened postoperative expectations due to increased demand for arm usage. As the trend toward increasing use of RSA continues, we emphasize the importance of careful patient selection to ensure optimal outcomes.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 2","pages":"Pages 127-133"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interest in reverse total shoulder arthroplasty is increasing! An analysis of publication frequency and Google Trends","authors":"Catherine M. Call BA ,&nbsp;Joseph B. Kahan MD","doi":"10.1053/j.sart.2024.10.002","DOIUrl":"10.1053/j.sart.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Total shoulder arthroplasty (TSA) procedure volume is increasing, as is reverse total shoulder arthroplasty (RTSA) procedure volume, which continues to make up a larger proportion of all TSA procedures performed. Whether growing procedure volume is associated with growing patient interest has not yet been assessed with the field of shoulder arthroplasty. The present study aimed to evaluate trends in public and scientific interest in RTSA compared to TSA by assessing Google Trends and publication frequency data, respectively.</div></div><div><h3>Methods</h3><div>Google Trends data and publication frequency data on PubMed were collected for RTSA and TSA between January 2010 and December 2023. Trend analyses were performed.</div></div><div><h3>Results</h3><div>Over the 13-year period between January 1, 2010 and December 31, 2023, Google Trends search data demonstrated that RTSA searches are growing as a share of TSA searches, indicating an upward trajectory for RTSA over the entirety of the study period. PubMed literature revealed RTSA represents a rising proportion of all TSA publications, increasing significantly from 31% to 58% of the total publications (<em>P</em> &lt; .001). Publications for both RTSA and TSA have increased 668% and 233%, respectively, over the study period.</div></div><div><h3>Conclusion</h3><div>RTSA encompasses an increasing portion of patient interest in TSA and, similarly, a growing share of publications on TSA. The significant upward trajectory of these trend lines over the entirety of the study period suggests both public and research interest in RTSA will continue to grow. Trends demonstrating rising public awareness and interest can inform surgeons planning for a future of increased demand for RTSA.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 1","pages":"Pages 100-105"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143284737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling highly crosslinked polyethylene vs. non–highly crosslinked polyethylene glenoid revision rates for anatomic shoulder arthroplasty in osteoarthritis including differing polyethylene glenoid fixation designs","authors":"David R.J. Gill MB ChB, FRACS, FAOrthA ,&nbsp;Sophia Corfield PhD (Hons) ,&nbsp;Dylan Harries BSc (Hons), PhD ,&nbsp;Richard S. Page BMedSci, MBBS, FRACS, FAOrthA","doi":"10.1053/j.sart.2024.06.003","DOIUrl":"10.1053/j.sart.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><div>We compared anatomic total shoulder arthroplasty (aTSA) for osteoarthritis to both highly crosslinked polyethylene (XLPE) and non–highly crosslinked polyethylene (non-XLPE) to determine the rate of revision for multiple patient and implant characteristics, modeling the effect of variation in glenoid fixation design (glenoid component type).</div></div><div><h3>Methods</h3><div>Data from a large national arthroplasty registry were analyzed for the period April 16, 2004, to December 31, 2022. The study population included all primary aTSA (stemmed and stemless shoulder arthroplasty) procedures with a primary diagnosis of osteoarthritis and performed using prostheses in current use. These procedures were grouped into 2 cohorts: all polyethylene-bearing glenoid components with either XLPE or non-XLPE. The cumulative percent revision was determined using Kaplan–Meier estimates of survivorship and hazard ratios from Cox proportional hazard models adjusted for age, sex, humeral head size, humeral fixation, type of primary (total stemmed or stemless anatomic), glenoid component type (modular and nonmodular metal-backed glenoid, cemented polyethylene glenoid, and polyethylene glenoid with modified central peg), and surgeon volume (after 2008). Possible interactions were examined. A subanalysis from January 1, 2017, captured the additional patient demographics of American Society of Anesthesiologists score, body mass index, and glenoid morphology.</div></div><div><h3>Results</h3><div>Of 11,003 aTSA procedures, the cumulative percent revision at 14 years for all XLPE glenoids (n = 3865) was 5.8% (95% confidence interval [CI] 3.9, 8.7), and 18.7% (95% CI 16.6, 21.0) for non-XLPE (n = 7138). XLPE had a lower rate of revision from 2 years (non-XLPE vs. XLPE 2 years + hazard ratio = 1.66, (95% CI 1.09, 2.53), <em>P</em> = .018) adjusting for age, sex, humeral head size, type of primary, humeral stem fixation, and glenoid component type. Overall, glenoid component type and polyethylene type were strongly associated (<em>P</em> &lt; .001 and <em>P</em> = .021, respectively) with all-cause aTSA revision rates. The difference between non-XLPE and XLPE is observed across all polyethylene glenoid types. When considering procedures performed between 2017 and 2022, XLPE vs. non-XLPE rates of revision were not significantly different with extended adjustment at subanalysis, but loosening did not predominate for non-XLPE until year 6 of follow-up.</div></div><div><h3>Conclusion</h3><div>Both the glenoid design and the type of polyethylene predict the revision rate for aTSA. However, the relative rates of revision between glenoid designs did not differ with polyethylene type. While the polyethylene type was not associated with aTSA revision rates in a more contemporary analysis, the incidence of loosening in non-XLPE prostheses combinations was higher from 6 years may explain this.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"34 4","pages":"Pages 843-853"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of primary language on access to specialized orthopedic care","authors":"Jessica V. Baran BS ,&nbsp;Jared Kushner BS ,&nbsp;Anna Redden BS ,&nbsp;Katelyn Kane BS ,&nbsp;Carlos Fernandez MD ,&nbsp;Shay V. Daji MD ,&nbsp;Garrett R. Jackson MD ,&nbsp;Vani J. Sabesan MD","doi":"10.1053/j.sart.2024.06.001","DOIUrl":"10.1053/j.sart.2024.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Language barriers can negatively impact the quality of care for non-English speaking patients. Lack of access to health-care providers who speak multiple languages or interpreters in medical offices can result in delayed appointment times, delayed treatment, and increased complications. Access to shoulder surgeons with subspecialty training is limited and this has been established which may further exacerbate the problem with access for these patients. The purpose of this study was to determine the effect of primary language spoken on access to specialty shoulder care in South Florida.</div></div><div><h3>Methods</h3><div>Three populous, diverse counties in South Florida were selected for data collection. Sixty-nine orthopedic offices were identified by Google search and selected via random number generator. Investigators used the Secret Shopper methodology to contact each office to schedule an appointment for a shoulder arthroplasty for a family member who spoke exclusively English or Spanish using a blocked phone number. The ability to schedule a new patient appointment with a fellowship-trained shoulder specialist, the waiting period for the scheduled appointment, and interpretation services for Spanish-speaking patients were collected.</div></div><div><h3>Results</h3><div>Of the 69 offices called, 35 met inclusion criteria. There were no significant differences in wait times for shoulder arthroplasty based on primary language spoken. There was no difference in wait time to see a shoulder specialist between Spanish (13.7 days) and English-speaking patients (12.9 days) (<em>P</em> = .835)). Wait times with a nonfellowship-trained orthopedic surgeon between Spanish and English-speaking patients was also not different (9.5 days and 11.96 days, respectively (<em>P</em> = .522). Similarly, no difference existed in phone call duration (<em>P</em> = .56), median income and wait times for a general orthopedic surgeon, with r = −0.26 (<em>P</em> = .105), or a shoulder specialist, with r = −0.19 (<em>P</em> = .22). Of the clinics accepting patients, 74.3% (n = 26/35) offered Spanish interpretation with 42.3% (n = 11/26) providing a multilingual physician, 26.9% (n = 7/26) a translating service, 23.1% (n = 6/26) had a staff member capable of translation, and 7.7% (n = 2/26) had an available professional interpreter.</div></div><div><h3>Conclusion</h3><div>While access to orthopedic specialty care may be similar for Spanish-speaking and English-speaking patients in South Florida, over 25% of clinics lack multilingual physicians or qualified interpreter access. This can negatively impact surgical decision-making, postoperative care and outcomes after shoulder surgery. It is essential the orthopedic community advocates for the proper resources to optimally assist surgeons and provide quality care for Spanish-speaking orthopedic patients.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"34 4","pages":"Pages 832-837"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of the factors associated with humeral head size as calculated by 3-dimensional computed tomography in patients with rotator cuff tears","authors":"Kohei Uekama MD,&nbsp;Takasuke Miyazaki PT, PhD,&nbsp;Shingo Maesako MD,&nbsp;Shogo Tsutsumi PT, PhD,&nbsp;Noboru Taniguchi MD, PhD","doi":"10.1053/j.sart.2024.07.004","DOIUrl":"10.1053/j.sart.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Despite the effectiveness of 3-dimensional computed tomography (3D-CT) for identifying bone and joint conditions, there are few clinical data on humeral head enlargement in patients with rotator cuff tears (RCTs), including cuff tear arthropathy (CTA). This study aimed to investigate the factors correlated with humeral head size measured through 3D-CT in patients with RCTs.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 43 preoperative patients who were diagnosed via RCTs. The severity of RCTs was classified into 3 types: small-medium tears, large-massive tears, and CTA. The 3D-radius was calculated from the raw radius data using 3D-CT and adjusted by height as a corrected-radius. The reliability of the 3D-radius measurements was calculated as the intraclass correlation coefficient. Various statistical analyses, including correlation coefficients, group comparisons, and multiple regression analyses, were used to explore factors associated with humeral head size.</div></div><div><h3>Results</h3><div>The interobserver reliability of the 3D-radius was 0.903. The corrected-radius on the affected side exhibited correlations with age (r = 0.598, <em>P</em> &lt; .001) and the acromion-humeral interval (r = −0.609, <em>P</em> &lt; .001). Group comparison between tear sizes, the CTA group had larger corrected-radius than the other groups (<em>P</em> = .001), with no significant difference between the small-medium tear and large-massive tear groups (<em>P</em> = .932). Multiple regression analysis adjusted for covariates revealed that the corrected-radius was correlated with age and the acromion-humeral interval (<em>P</em> &lt; .05, R² = 0.474).</div></div><div><h3>Conclusion</h3><div>These findings provide valuable clinical insights into the factors associated with humeral head enlargement, particularly in patients with RCTs. The measurement method we used holds promise for informing the selection of artificial head sizes during the preoperative planning of total shoulder arthroplasty.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"34 4","pages":"Pages 900-906"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of mental health on major complications following total shoulder arthroplasty","authors":"Kenny Ling MD ,&nbsp;Emily N. Moya BA ,&nbsp;Jack Tesoriero MD ,&nbsp;Robert Martino BS ,&nbsp;David E. Komatsu PhD ,&nbsp;Edward D. Wang MD","doi":"10.1053/j.sart.2024.07.007","DOIUrl":"10.1053/j.sart.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><div>The volume of total shoulder arthroplasty (TSA) procedures has seen a remarkable surge over the past decade in the United States. Recent research has shown an association between depression and poorer postoperative outcomes following shoulder, hip, and knee arthroplasties. The purpose of this study was to examine the relationship between patients with a diagnosis of depression and/or anxiety and the risk of major postoperative complications after TSA.</div></div><div><h3>Methods</h3><div>The TriNetX Research Network database was queried on May 30, 2023. Patient cohorts and outcomes were defined using International Classification for Disease, 10^th Edition diagnosis codes and Current Procedural Terminology codes. After propensity score matching, the two cohorts were analyzed for differences in major outcomes within two years following the initial procedure.</div></div><div><h3>Results</h3><div>Of the 45,838 patients who underwent TSA identified in TriNetX, 15,074 patients were included in the depression/anxiety cohort and 30,764 were included in the no depression/anxiety cohort. Propensity score matching was performed to match 13,392 patients from each cohort. Compared to patients with no depression nor anxiety, patients with either depression and/or anxiety were identified to have a higher risk for dislocation (odds ratio [OR] 1.502, 95% confidence interval [CI] 1.285-1.756; <em>P</em> &lt; .001), periprosthetic joint infection (OR 1.309, 95% CI 1.123-1.525; <em>P</em> = .001), periprosthetic fracture (OR 1.661, 95% CI 1.341-2.056; <em>P</em> &lt; .001), and revision TSA (OR 1.316, 95% CI 1.150-1.506; <em>P</em> &lt; .001) within 2 years after the initial procedure.</div></div><div><h3>Conclusion</h3><div>Overall, this study showed that patients who have depression and/or anxiety have a higher risk for dislocation, periprosthetic joint infection, revision TSA, and periprosthetic fracture within two years after TSA.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"34 4","pages":"Pages 924-927"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal rotation-based activities of daily living show limitations following reverse shoulder arthroplasty versus anatomic shoulder arthroplasty","authors":"Galo C. Bustamante BS,&nbsp;Erryk S. Katayama BS,&nbsp;Mustaqueem Pallumeera BS,&nbsp;Louis S. Barry BS,&nbsp;John S. Barnett BS,&nbsp;Akshar V. Patel BS,&nbsp;Gregory L. Cvetanovich MD,&nbsp;Julie Y. Bishop MD,&nbsp;Ryan C. Rauck MD","doi":"10.1053/j.sart.2024.07.001","DOIUrl":"10.1053/j.sart.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div>One of the more common limitations after reverse total shoulder arthroplasty (rTSA) is limited internal rotation (IR). Outcomes after rTSA are commonly reported as patient-reported outcome measures (PROMs) but are rarely assessed by specific activities of daily living (ADLs). Analyzing ADLs evaluates for specific motions from PROMs. The purpose of this study is to investigate the deficit in IR following rTSA through ADLs.</div></div><div><h3>Methods</h3><div>A retrospective case-control study was conducted using institutional medical records. Patients who underwent total shoulder arthroplasty between 2009 and 2020 were reviewed for demographic and clinical variables (type of arthroplasty, indication, range of motion and strength). PROMs were taken by phone at 2-year minimum follow-up. Statistics were calculated as two-tailed using Chi-square or simple t-tests as appropriate.</div></div><div><h3>Results</h3><div>Among 208 patients, 114 aTSA, and 94 rTSA were identified and included in this study. Both groups reported significant increases in range of motion and strength postoperatively. PROMs were mostly similar between aTSA and rTSA (Single Assessment Numeric Evaluation 83.4 ± 17.1 vs. 82.3 ± 18.4, <em>P</em> = .643; visual analog scale Pain 2.2 ± 2.8 vs. 1.8 ± 2.4, <em>P</em> = .247), while Simple Shoulder Test did show a difference (9.2 ± 2.8 vs. 7.8 ± 3.2, <em>P</em> = .001) with higher scores in the aTSA cohort. The ADLs which showed significant disparity between aTSA and rTSA were toileting (<em>P</em> = .001), donning a coat (<em>P</em> = .017), reaching one’s back (<em>P</em> = .017), as well as throwing overhand (0.013) with rTSA patients reporting more difficulty in all these ADLs.</div></div><div><h3>Conclusion</h3><div>Both aTSA and rTSA are safe and efficacious options for shoulder replacement, as evidenced by high Single Assessment Numeric Evaluation and low visual analog scale pain scores and should be used according to their established indications. Surgeons may counsel rTSA patients about potential increased deficits in ADLs reliant on IR such as managing toileting and dressing compared to aTSA recipients.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"34 4","pages":"Pages 877-883"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840007","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}