Seminars in Arthroplasty最新文献

{"title":"Reverse total shoulder arthroplasty is associated with decreased complication and reoperation rates compared to open reduction and internal fixation for three- and four-part proximal humerus fractures in adult patients","authors":"Sailesh V. Tummala MD ,&nbsp;Alejandro M. Holle BS ,&nbsp;Cara Lai MD ,&nbsp;Brian Miller MD ,&nbsp;John M. Tokish MD","doi":"10.1016/j.sart.2025.151515","DOIUrl":"10.1016/j.sart.2025.151515","url":null,"abstract":"<div><h3>Background</h3><div>Reverse total shoulder arthroplasty (rTSA) has become an increasingly popular surgical option for treating complex proximal humerus fractures with expanding indications in younger patients. The purpose was to compare the complication and reoperation rates between rTSA) and open reduction and internal fixation (ORIF) for 3- or 4-part proximal humerus fractures, and to analyze the impact of patient age on these outcomes. The secondary aim was to evaluate complications of patients undergoing rTSA following ORIF compared to primary rTSA for proximal humerus fracture.</div></div><div><h3>Methods</h3><div>A retrospective cohort study using a large administrative claims database was conducted to evaluate patients with 3- or 4-part proximal humerus fractures. Patients were grouped by surgical management and indication (rTSA vs. ORIF for 3- or 4-part fractures, 3-part fractures only, or 4-part fractures only), and complication and reoperation rates within 2 years of the index surgery were compared. To explore the effect of age, cohorts were further subdivided into 5-year increments from 50 to 85 years old, and multivariable logistic regressions were employed to analyze outcomes.</div></div><div><h3>Results</h3><div>A total of 3,081 patients underwent rTSA and 4,160 patients underwent ORIF for 3- or 4-part fracture. ORIF patients were 1.58 times more likely to experience a complication within 2 years (95% confidence interval: 1.39-1.79, <em>P</em> &lt; .001) and 2.32 times more likely to have a reoperation within 2 years compared to rTSA patients (95% confidence interval: 1.79-3.04, <em>P</em> &lt; .001). ORIF for 3-part fractures in patients aged 65-79 were more likely to have a complication and reoperation within 2 years, while those younger than 65 and aged 80-84 showed no difference compared to rTSA. For 4-part fractures, all age groups except those over 80 showed a higher complication rate, and patients older than 55 showed a higher reoperation rate within 2 years of ORIF as compared to rTSA.</div></div><div><h3>Conclusion</h3><div>ORIF of three- and four-part proximal humerus fractures was noted to have a significantly higher rate of 2-year complications and reoperations for patients older than 55 years of age as compared to rTSA. In patients with three-part fractures, rTSA was noted to have significantly lower complication and reoperation rates in those older than 65. In patients with four-part fractures, rTSA was noted to have a lower complication and reoperation rates in those older than 55. When comparing primary rTSA to rTSA after ORIF for 3- and 4- part proximal humerus fractures, there was no significant difference in complication rate; however, there was a significantly increased likelihood of reoperation within 2 years with revision cases.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"36 1","pages":"Article 151515"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841503","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":"Perceived influence of preoperative information in reverse total shoulder arthroplasty patients","authors":"Stephanie M. Barbone DHSc, OTR/L, CHT ,&nbsp;Zachary R. Zimmer MD, FAAOS ,&nbsp;David Lutton MD, FAAOS ,&nbsp;Norman W. Gill PT, DSc","doi":"10.1016/j.sart.2025.151537","DOIUrl":"10.1016/j.sart.2025.151537","url":null,"abstract":"<div><h3>Background</h3><div>While prehabilitation has shown benefits in other joint arthroplasties, specific preoperative guidance for reverse total shoulder arthroplasty (rTSA) remains underdeveloped. Patients often enter surgery with varying levels of preparedness and understanding, which can be shaped by inconsistent communication and limited resources. This study examines how patients perceive the preoperative education they received and how it influenced their recovery experiences.</div></div><div><h3>Methods</h3><div>A qualitative instrumental case study was conducted. Sixteen adult patients who underwent elective rTSA in the previous eight months were recruited from orthopedic clinics and a university hospital rehabilitation center in Washington, D.C. Semistructured interviews explored patients' expectations, pain management, functional challenges, and support systems. Transcripts were coded using thematic analysis guided by interpretive description to identify recurring patterns and insights.</div></div><div><h3>Results</h3><div>Four primary themes emerged from the analysis: communication with the health care team, pain expectations and management, caregiver support in recovery, and postoperative functional limitations. Participants described how thorough communication fostered trust in their surgeons and influenced their preparedness. Pain experiences varied, with many expressing confusion about opioid protocols and nerve block management. Caregiver support was universally cited as essential, particularly for patients recovering alone or undergoing surgery on their dominant side. Patients reported significant challenges with basic activities, such as dressing and bathing, often underestimating these limitations preoperatively. Sleep disruption and sling use were also highlighted as preoperative education topics that hindered or supported recovery.</div></div><div><h3>Conclusion</h3><div>This study highlights the multifaceted nature of recovery following rTSA and emphasizes the need for tailored, practical preoperative education. While technical competence is essential, the provider's communication style and clarity are equally important in fostering patient trust and understanding. Patients benefit from education that sets realistic expectations about pain, sleep, daily functioning, and the critical role of caregiver support. By elevating the voices of patients, this study provides a deeper understanding of the patient experience after rTSA. It also suggests actionable opportunities for clinicians to enhance the content and delivery of preoperative counseling, ultimately supporting a more informed recovery journey for patients undergoing rTSA.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"36 1","pages":"Article 151537"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926414","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":"Primary reverse total shoulder arthroplasty for rotator cuff tearing without osteoarthritis","authors":"Paul J. Pottanat MD ,&nbsp;Mitchell Negus BS ,&nbsp;Hyeongmin Kim MS ,&nbsp;Josie Elwell PhD ,&nbsp;Chris P. Roche MSE, MBA ,&nbsp;Brandon L. Rogalski MD ,&nbsp;Josef K. Eichinger MD ,&nbsp;Richard J. Friedman MD, FRCSC","doi":"10.1053/j.sart.2025.08.003","DOIUrl":"10.1053/j.sart.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Reverse total shoulder arthroplasty (rTSA) is an effective treatment for the management of rotator cuff tears (RCTs) and osteoarthritis (OA). However, little data exist on the outcomes of patients undergoing rTSA with RCT without OA compared to those with RCT and OA. The purpose of this study is to compare the clinical and radiographic outcomes of patients undergoing rTSA for RCT without OA compared to those with RCT and OA (including RCT arthropathy) with a 2-year minimum follow-up.</div></div><div><h3>Methods</h3><div>Prospectively collected data were extracted from an international registry of patients who underwent rTSA using the Exactech Equinoxe implant system from 2007 to 2022 with a minimum 2-year follow-up. Patients were separated into 2 groups: RCTs with OA and RCTs without OA. The groups were matched 3:1 based on age, gender, body mass index, and follow-up. Range of motion (ROM), patient-reported outcome measures (PROMs), visual analog pain score, complication and revision rates, humeral radiolucent lines, and scapular notching were compared between groups. The data were analyzed using Welch's <em>t</em>-test for continuous variables and Fisher’s exact test for categorical variables, all with significance set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>There were 2,392 total patients, with 1794 patients with RCT with OA and 598 patients with RCT without OA, with a mean follow-up of 51 months each. Patient satisfaction was high in both cohorts, with 92% of patients in the RCT with OA group being better compared to 93% in the RCT without OA group (<em>P</em> = .651). Postoperatively, there were no significant differences in ROM or PROM that exceeded the associated Minimal Clinically Important Difference, except for better internal rotation in the RCT with the OA group (<em>P</em> = .001). There were no significant differences in scapular notching (<em>P</em> = .434) or humeral stem radiolucent lines (<em>P</em> = .075). Patients who underwent rTSA with RCT without OA had significantly lower complications (4.0% vs. 8.3%; <em>P</em> &lt; .001) and revision (0.5% vs. 3.1%; <em>P</em> &lt; .001) rates.</div></div><div><h3>Conclusion</h3><div>Patients undergoing rTSA for RCT with and without OA had similar PROM, ROM (except for internal rotation), radiographic outcomes, and patient satisfaction rates at minimum 2-year follow-up. Patients undergoing rTSA for RCT without OA had lower rates of complications and revisions compared to those with RCT and OA. rTSA is a viable treatment option for patients without OA and failed rotator cuff repairs or irreparable RCTs.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"36 1","pages":"Article 151497"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188015","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":"Comparing outcomes of inpatient vs. outpatient total shoulder arthroplasty","authors":"J. Ambrose Martino BS,&nbsp;Maxwell A. Northrop BS,&nbsp;Brandon L. Rogalski MD,&nbsp;Richard J. Friedman MD, FRCSC","doi":"10.1053/j.sart.2025.09.005","DOIUrl":"10.1053/j.sart.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Total shoulder arthroplasty (TSA) is increasingly performed as an outpatient procedure. The purpose of this study is to compare the clinical outcomes and complications of outpatient vs. inpatient TSA.</div></div><div><h3>Methods</h3><div>The TriNetX database from 2005 to 2025 was used to identify 2 cohorts of patients who underwent TSA. Cohort 1 were operated on in an inpatient setting, while cohort 2 were operated on in an outpatient setting. Propensity score matching was performed using a 1:1, matching based on preoperative demographic characteristics and comorbidities, including age, gender, and body mass index. After matching, each cohort was composed of 25,557 cases. Both medical and surgical complications were collected within the 5-year follow-up window. Independent <em>t</em>-tests and relative risk ratios (RRs) were completed within the TriNetX database.</div></div><div><h3>Results</h3><div>Significantly increased risks were observed for several medical complications in the inpatient cohort, including an increased risk of analgesic prescription (RR:1.109), readmission rate (RR:1.392), occupational utilization (RR: 1.314), mortality (RR: 1.387), thrombosis (RR: 1.355), sepsis (RR: 1.282), acute respiratory distress syndrome (RR: 1.295), pneumonia (RR:1.214), pulmonary embolism (RR: 1.215), cellulitis (RR: 1.2), transfusion rates (RR: 1.448), bleeding (RR: 1.369), urinary tract infection (RR: 1.27), gastrointestinal (RR: 1.288), stroke (RR: 1.306), cardiovascular complications (RR: 1.22), acute renal failure (1.311), and respiratory complications (RR: 1.311). Several surgical complications were also found to have increased risk in the inpatient cohort, including revisions (RR: 1.165), prosthetic complications (RR: 1.28), broken hardware (RR: 1.258), periprosthetic infection (RR: 1.408), removal of hardware (RR: 1.303), mechanical loosening (RR: 1.398), dislocation (RR: 1.236), infection following procedure (RR: 1.346), wound dehiscence (RR: 1.258), and débridement (RR: 1.305).</div></div><div><h3>Conclusion</h3><div>Outpatient TSA is associated with reduced risk of periprosthetic complications, infection, cardiovascular events, thrombosis, bleeding, and transfusion up to 5 years postoperatively. Outpatients utilized less health care postoperatively, as seen by lower risk of readmission, revision, mortality, emergency department, and occupational therapy utilization compared to inpatient TSA patients. These findings support that outpatient TSA is safe and may be advantageous for appropriately selected patients.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"36 1","pages":"Article 151505"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188051","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":"Clinical, radiographic, and survivorship outcomes of ceramic head shoulder arthroplasty: a systematic review","authors":"Neal Hitesh Patel BSc(Hons), MBBS ,&nbsp;Jonathan Bennett BA(Hons) ,&nbsp;Veronica Phillips BA(Hons), MPhil, PhD ,&nbsp;Sandeep Krishan Nayar BSc(Hons), MBBS, MSc(Dist), FRCS (Tr&Orth) ,&nbsp;Niel Kang MA(Cantab), FRCS(Tr&Orth)","doi":"10.1053/j.sart.2025.07.011","DOIUrl":"10.1053/j.sart.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Ceramic humeral heads are increasingly used in shoulder arthroplasty due to their superior wear properties and potential advantages over conventional metal prostheses. This systematic review evaluated the clinical and radiographic outcomes of ceramic head components in shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>The study protocol was registered with the international systematic review registry (CRD42024593229). A search of the Medline, Embase, Cochrane Library, Scopus, and Web of Science databases was conducted in September 2024. Studies reporting on shoulder arthroplasty using ceramic heads, regardless of indication, were included. Primary outcomes included patient-reported outcome measures, range of motion (ROM), complications, revision rates, implant survival, and radiographic outcomes. Risk of bias was assessed using the Cochrane Risk Of Bias In Non-Randomised Studies of Interventions (ROBINS)-I tool.</div></div><div><h3>Results</h3><div>Ten studies (7,486 patients, mean age 67.2 years) were included with a total of 2,874 ceramic head arthroplasties performed. Nine studies were rated as having “moderate” risk of bias and one as “low” risk of bias. Mean follow-up was 7.9 years (1-11 years). Nine studies assessed anatomic total shoulder arthroplasty (aTSA), 2 included both hemiarthroplasty and aTSA, and one evaluated cementless ceramic-coated humeral resurfacing. Seven studies reported significant improvements in patient-reported outcome measures (American Shoulder and Elbow Surgeons, Shoulder Pain and Disability Index, Constant-Murley Score, Oxford Shoulder Score, and Simple Shoulder Test), and 5 reported increased ROM. Glenoid radiolucency (Lazarus grade ≥2) was observed in 6%, humeral radiolucency in 4.6%, and superior humeral migration in 18.7%. The overall complication rate was 6.6%, with revision rates of 1.8% for aTSA and 5% for hemiarthroplasty. Rotator cuff failure was the most common cause for revision (27.4%). Two studies comparing ceramic and metal humeral heads found that ceramic aTSA was associated with reduced glenoid osteolysis and improved implant survival.</div></div><div><h3>Conclusion</h3><div>Ceramic humeral heads in shoulder arthroplasty are associated with favorable functional outcomes, ROM improvements, and promising implant longevity. Comparative studies suggest potential advantages over metal heads. Further research is needed to establish long-term efficacy and comparative performance against metal and pyrocarbon alternatives.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"36 1","pages":"Article 151494"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188049","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":"Autoimmune disease impact on total elbow arthroplasty","authors":"Melanie Bertolino BS,&nbsp;John W. Moore BS,&nbsp;Brandon L. Rogalski MD,&nbsp;Josef K. Eichinger MD,&nbsp;Richard Friedman MD, FRCSC","doi":"10.1053/j.sart.2025.07.009","DOIUrl":"10.1053/j.sart.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Total elbow arthroplasty (TEA) is a well-established surgical intervention for patients with end-stage elbow arthritis, particularly those with rheumatoid arthritis (RA). While TEA alleviates pain and improves function, there is a paucity of literature examining its comparative outcomes across different autoimmune conditions. The purpose of this study is to compare TEA perioperative outcomes and healthcare utilization between patients with RA and those with other autoimmune diseases.</div></div><div><h3>Methods</h3><div>The Nationwide Readmissions Database (NRD) was queried from 2016 to 2022 to compare outcomes between patients undergoing TEA with RA and those with other autoimmune conditions. Patients who received a diagnosis of an autoimmune condition within 6 months of surgery were identified using International Classification of Diseases, 10th Revision Clinical Modification codes. Logistic regression was performed to identify independent predictors of postoperative complications, with significance set at <em>P</em> &lt; .05 and adjusted using Bonferroni correction. Chi-square and student <em>t</em>-tests identified differences in categorical and continuous variables, respectively.</div></div><div><h3>Results</h3><div>Preoperative comorbidity analysis showed RA patients had lower rates of dementia, fluid and electrolyte disorders, and hypothyroidism, but higher rates of smoking. RA patients exhibited significantly higher 180-day complication rates (49% vs. 31%; odds ratio [OR]: 2.1 [1.4-3.1]; <em>P</em> &lt; .001) and 180-day revision rates (20% vs. 6.8%; OR: 3.5 [1.7-6.8]; <em>P</em> &lt; .001). Logistic regression analysis confirmed RA as an independent predictor of increased 180-day complication rates (OR: 2.7 [1.7-4.2]; <em>P</em> &lt; .001) and 180-day revision rates (OR: 4.1 [2.0-8.6]; <em>P</em> &lt; .001). RA patients had shorter average lengths of stay (3.0 vs. 3.8 days; <em>P</em> = .04) and were more likely to be discharged routinely (70% vs. 52%; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>RA patients undergoing TEA demonstrated significantly higher rates of postoperative complications and revisions compared to those with other autoimmune conditions. Despite shorter hospital stays and more routine discharges, the increased complication and revision rates highlight the importance of careful risk stratification and specialized care for RA patients undergoing TEA. Orthopedic surgeons should consider these outcomes when counseling RA patients and planning their perioperative care to potentially mitigate these elevated risks.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"36 1","pages":"Article 151492"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188208","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":"","authors":"","doi":"10.1053/S1045-4527(25)00132-4","DOIUrl":"10.1053/S1045-4527(25)00132-4","url":null,"abstract":"","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"36 1","pages":"Article 151533"},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188021","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":"Are orthopedic shoulder and elbow surgeons at risk for noise-induced hearing loss?","authors":"Matthew J. Schultz DO ,&nbsp;William T. DiCiurcio III DO ,&nbsp;Stephanie A. Kwan DO ,&nbsp;Jeffrey C. Lynch DO ,&nbsp;Dennis DeBernardis DO ,&nbsp;Luke Austin MD","doi":"10.1053/j.sart.2025.05.007","DOIUrl":"10.1053/j.sart.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Exposure to noise levels greater than 85 decibels [dB] is associated with increased incidence of hearing loss. However, the risk that occupational noise exposure poses to orthopedic shoulder and elbow (S&amp;E) surgeons is poorly understood. This study aims to (1) quantify the noise exposure of S&amp;E surgeons in the operating room to determine if they are exposed to harmful noise levels and (2) identify which procedures pose the greatest risk of noise-induced hearing loss.</div></div><div><h3>Methods</h3><div>Intraoperative audio recordings were collected during S&amp;E procedures via a wearable microphone worn under standard sterile surgical garb. S&amp;E procedures were characterized as open reduction and internal fixation, arthroscopic soft tissue procedures, open soft tissue procedures, and arthroplasty. The highest sound pressure level (maximum dB levels [MDLs]) and the average dB level projected over an 8-h period (time-weighted average) were reported. The percentage of allowable daily noise dose was reported as “dose,” and the measured dose projected for over 8-h was reported as “projected dose.”</div></div><div><h3>Results</h3><div>We collected 116 recordings consisting of 65 arthroplasties, 5 open reduction and internal fixation, 11 open soft tissue procedures (distal bicep tendon repairs), and 35 arthroscopic soft tissue procedures. The average MDL was greater than the average control MDL for all S&amp;E procedures and ranged from 88.7 to 112.6 dB. Shoulder arthroplasty had the highest average dose (1.4%), projected dose (8.4%), and time-weighted average (64.6 dB).</div></div><div><h3>Conclusion</h3><div>All recorded procedure types exposed surgeons to MDLs greater than 85 dB. Shoulder arthroplasty demonstrated the highest average exposure to harmful doses of noise and appears to pose the greatest risk for occupational noise exposure. Strategies should be considered to minimize the risk of noise-induced hearing loss amongst surgeons.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 4","pages":"Pages 599-603"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685930","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":"Anatomic total shoulder arthroplasty using a short humeral stem and a non-augmented, minimally cemented all-polyethylene glenoid: minimum 2-year outcome and predictors of clinical failure","authors":"Brian P. Kurcz MD ,&nbsp;Dennis A. DeBernardis DO ,&nbsp;Aaron Roberts DO ,&nbsp;Peter Regala MD ,&nbsp;Carl J. Replogle ,&nbsp;Cassie M. Fleckenstein MS ,&nbsp;Joseph Nolan PhD ,&nbsp;Samer S. Hasan MD, PhD","doi":"10.1053/j.sart.2025.04.007","DOIUrl":"10.1053/j.sart.2025.04.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Anatomic total shoulder arthroplasty (aTSA) using standard (non-augmented) glenoid implants has demonstrated excellent clinical results, but concerns have been raised regarding their use in patients with posterior glenoid wear. The primary purpose of this study is to investigate short-term patient-reported outcomes (PROs) and overall active range of motion in patients who underwent aTSA using short humeral stems and standard glenoid implants for glenohumeral arthritis with minimal or concentric wear and with posterior glenoid wear. The secondary purpose was to the determine predictors of an inferior outcome or reoperation following aTSA using this construct.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Patients in this study underwent aTSA with minimal glenoid reaming to achieve &gt;90% contact of a pegged, all-polyethylene standard glenoid implant, inserted with minimal cement. Plain radiographs, active range of motion, and PROs—comprising American Shoulder and Elbow Surgeons (ASES), simple shoulder test, and visual analog scale pain scores—were obtained preoperatively and at final follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;One hundred twenty-eight consecutive aTSAs in 122 patients (75 males) with mean age of 66 years (range 48-84) were reviewed. Thirteen patients were lost to follow-up, 6 patients were deceased or had cognitive impairment precluding evaluation, and 5 patients underwent early revision for subscapularis failure, leaving 104 aTSAs for evaluation at minimum 2-year follow-up (mean 3 years, range 2-5.6 years). Twenty-four shoulders had undergone previous surgery. Fifty-nine patients had posterior glenoid wear (Walch B2 or B3) and 47 had concentric or minimal glenoid wear (Walch A1, A2, or B1). Forward elevation improved from 101° ± 25° to 147° ± 17°, abduction from 87° ± 26° to 145° ± 23°, external rotation from 21° ± 15° to 45° ± 13°, and internal rotation from the sacrum to thoracolumbar junction (&lt;em&gt;P&lt;/em&gt; &lt; .001 for all). Overall, ASES improved from 41 ± 20 to 89 ± 13, simple shoulder test from 4.5 ± 2.9 to 10.2 ± 2.5, and visual analog scale pain from 5.5 ± 2.5 to 0.7 ± 1.3 (&lt;em&gt;P&lt;/em&gt; &lt; .001). Ten patients had a final ASES score &lt;70, which was associated with a history of previous surgery (&lt;em&gt;P&lt;/em&gt; = .03). The degree of posterior glenoid wear did not influence any outcome score. Eight patients underwent subsequent ipsilateral shoulder surgery including 5 (4%) undergoing revision to reverse shoulder arthroplasty for subscapularis insufficiency (2 following traumatic injury). No revisions for prosthetic joint infection or humeral or glenoid implant loosening were performed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;aTSA using a minimally cemented standard glenoid implant following partial version correction for Walch B2 and B3 glenoids leads to marked improvements in ROM and PROs, regardless of glenoid wear pattern. No reoperations were performed for glenoid or humeral loosening or infection at","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 4","pages":"Pages 539-546"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685759","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":"Introduction of a new outcome measure for total shoulder arthroplasty: subjective patient outcome tracker (SPOT)","authors":"B. Gage Griswold MD,&nbsp;Brian P. Davis MD,&nbsp;Hayden B. Schuette DO,&nbsp;Benjamin W. Sears MD,&nbsp;Andrea Stapleford BS,&nbsp;Libby Mauter MSPT,&nbsp;Jacqueline Bader MS,&nbsp;Mallory Boyd MS,&nbsp;Armodios M. Hatzidakis MD","doi":"10.1053/j.sart.2025.05.001","DOIUrl":"10.1053/j.sart.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Patient-reported outcome measures (PROMs) provide a quantifiable rating of a patient's subjective symptoms prior to and following treatment of shoulder pathology. Shoulder Subjective Patient Outcome Tracker (SPOT) is a novel outcomes measure with 10 satisfaction domains to pinpoint shoulder-specific functions. The purpose of this study is to introduce and demonstrate the utility of SPOT for patients undergoing total shoulder arthroplasty<span>. The authors hypothesize SPOT will demonstrate high correlations to existing PROMs with a corresponding large effect size.</span></div></div><div><h3>Methods</h3><div><span>Over a 1-year evaluation period, SPOT, American Shoulder and Elbow Surgeons (ASES) assessment, and Single Assessment Numeric Evaluation (SANE) scores were administered preoperatively and at 2 years postoperatively for patients undergoing anatomic total shoulder arthroplasty<span> (aTSA) and reverse shoulder arthroplasty (rTSA). Additionally, nonsurgical patients with glenohumeral </span></span>osteoarthritis were administered SPOT at 2 separate time points. Interoutcome agreement, correlation, and sensitivity of SPOT to ASES and SANE were evaluated, and the floor/ceiling effect of SPOT was assessed. Test-retest reliability was conducted on the nonsurgical cohort.</div></div><div><h3>Results</h3><div>A total of 139 patients were included with 73 postoperative aTSA and 66 postoperative rTSA patients. Twelve patients managed nonoperatively were included in test-retest analysis. Preoperatively, there was low correlation between SPOT and ASES and moderate correlation between SPOT and SANE. At 2 years postoperatively, there was high correlation between SPOT and ASES and between SPOT and SANE. There was good agreement between SPOT and ASES in both aTSA and rTSA cohorts and between SPOT and SANE in the aTSA cohort. Additionally, the large effect size of SPOT was similar to the effect size of ASES and SANE. There was high correlation in the test-retest evaluation in a nonoperative cohort indicating reliability of SPOT at the 2 time points assessed.</div></div><div><h3>Conclusion</h3><div>SPOT is a shoulder-specific, effective PROM with a low administrative burden, tailored for patients undergoing aTSA or rTSA. It demonstrates high reliability, strong correlations, and a large effect size comparable to established shoulder-specific PROMs. SPOT is more discriminatory and specific than the SANE score, offering valuable, detailed insights into patients’ perceived deficits before and after shoulder arthroplasty.</div></div>","PeriodicalId":39885,"journal":{"name":"Seminars in Arthroplasty","volume":"35 4","pages":"Pages 553-560"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685809","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}