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Revision Reverse Total Shoulder Arthroplasty: Current Concepts and Operative Strategies
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1016/j.oto.2024.101150
Vaibhav R. Tadepalli MD , Vaya Chhabra , Pradip Ramamurti MD , Richard F. Nauert MD , Brian C. Werner MD
{"title":"Revision Reverse Total Shoulder Arthroplasty: Current Concepts and Operative Strategies","authors":"Vaibhav R. Tadepalli MD ,&nbsp;Vaya Chhabra ,&nbsp;Pradip Ramamurti MD ,&nbsp;Richard F. Nauert MD ,&nbsp;Brian C. Werner MD","doi":"10.1016/j.oto.2024.101150","DOIUrl":"10.1016/j.oto.2024.101150","url":null,"abstract":"<div><div>As the number of reverse total shoulder arthroplasties (rTSA) in the United States continues to increase, so will the number of revisions rTSAs conducted. Common indications for revision rTSA include instability, infection, humeral or glenoid component loosening or periprosthetic humeral fracture, and each indication for revision warrants specific preoperative management and intraoperative strategies. Accurate diagnosis and management of the patient is key, as failure to recognize the correct indication for revision may result in failure of the revision surgery. Revision rTSA is a technically challenging procedure. However, with diligent preoperative planning including serologic evaluation for infection, evaluation of bone loss and implant stability with computed tomography, anticipating need for bone grafting, and detailed identification of implanted components to plan for explantation, surgeons can avoid common pitfalls in the operating room. This review article will discuss the major indications for revision rTSA and provide insight and technical tips to assist with the surgical management of these challenging cases.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101150"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743185","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}
引用次数: 0
A Review of Preoperative Planning and Technical Considerations for Anatomic Total Shoulder Arthroplasty
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1016/j.oto.2024.101147
Mikalyn T. DeFoor MD , Robert U. Hartzler MD , Andrew J. Sheean MD
{"title":"A Review of Preoperative Planning and Technical Considerations for Anatomic Total Shoulder Arthroplasty","authors":"Mikalyn T. DeFoor MD ,&nbsp;Robert U. Hartzler MD ,&nbsp;Andrew J. Sheean MD","doi":"10.1016/j.oto.2024.101147","DOIUrl":"10.1016/j.oto.2024.101147","url":null,"abstract":"<div><div>Anatomic total shoulder arthroplasty (aTSA) is best performed in the setting of glenohumeral joint osteoarthritis with an intact rotator cuff tear in patients with symptoms refractory to appropriate nonoperative treatment. Mid- to long-term follow-up supports overall high patient satisfaction with low complications rates. As reverse total shoulder arthroplasty (rTSA) allows the surgeon to manage a broader range of shoulder problems with greater technical ease and fewer complications, it has become the more commonly used option over aTSA. Specifically, glenoid deformity, joint incongruity, and rotator cuff deficiency pose challenging technical considerations for aTSA. The purpose of this article is to review the appropriate patient selection, preoperative planning, perioperative and intraoperative technical considerations required to achieve a successful outcome if aTSA is chosen.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101147"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743187","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}
引用次数: 0
Revision Anatomic Total Shoulder Arthroplasty Surgical Technique/Tips and Tricks
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1016/j.oto.2024.101148
Benjamin E. Neubauer , Justin W. Griffin
{"title":"Revision Anatomic Total Shoulder Arthroplasty Surgical Technique/Tips and Tricks","authors":"Benjamin E. Neubauer ,&nbsp;Justin W. Griffin","doi":"10.1016/j.oto.2024.101148","DOIUrl":"10.1016/j.oto.2024.101148","url":null,"abstract":"<div><div>In the United States, the use of total shoulder arthroplasty has grown significantly over the past decade, leading to an increased need for revision total shoulder arthroplasty. The most common causes for revision include instability, rotator cuff deficiency, infection, fractures, and component loosening. Although revisions are sometimes unavoidable, thoughtful preoperative planning and proper implant positioning, among other mitigation strategies, can help reduce this risk. A comprehensive evaluation is essential for determining the appropriate treatment modality, with computed tomography arthrography and metal suppression magnetic resonance imaging being particularly helpful depending on the etiology. Initial treatments may include conservative approaches, such as analgesic medications and physical therapy, but more commonly, surgical intervention is required. This typically involves revision total shoulder arthroplasty or conversion to reverse total shoulder arthroplasty, and in rare cases diagnostic arthroscopy or arthroscopic rotator cuff repair. Surgeons should be prepared for all potential treatments and complications, and a thorough work-up ensures that all possible scenarios are accounted for.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101148"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743184","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}
引用次数: 0
Reverse Shoulder Arthroplasty for the Treatment of Proximal Humerus Fractures
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1016/j.oto.2024.101151
Ehab M. Nazzal, Jaren LaGreca, Matthew F. Gong, Matthew Como, Jonathan D. Hughes
{"title":"Reverse Shoulder Arthroplasty for the Treatment of Proximal Humerus Fractures","authors":"Ehab M. Nazzal,&nbsp;Jaren LaGreca,&nbsp;Matthew F. Gong,&nbsp;Matthew Como,&nbsp;Jonathan D. Hughes","doi":"10.1016/j.oto.2024.101151","DOIUrl":"10.1016/j.oto.2024.101151","url":null,"abstract":"<div><div>Proximal humerus fractures (PHFs) are relatively common fractures that are especially prevalent amongst the geriatric population. Various fracture patterns exist, ranging from minimally displaced fractures to fracture dislocations with multiple fragments. Traditionally, treatment strategies have included nonoperative management with a sling and gradual return to range of motion, as well as both open reduction internal fixation and hemiarthroplasty. Recently, there has been an increase in the frequency of utilization of reverse shoulder arthroplasty (RSA) as a treatment option for PHFs, to maximize mobility and function. The purpose of this article is to review current concepts for the treatment of PHFs, with a special focus on indications, technical pearls, clinical/functional outcomes, and complications for RSA as a definitive management strategy.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101151"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743190","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 Board (pick up from previous issue w/updates)
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1053/S1048-6666(24)00067-3
{"title":"Editorial Board (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1048-6666(24)00067-3","DOIUrl":"10.1053/S1048-6666(24)00067-3","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101158"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743180","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}
引用次数: 0
Revolutionizing Shoulder Arthroplasty: The Transformative Impact of Extended Reality, Robotics, and Artificial Intelligence on Training, Planning, and Execution
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1016/j.oto.2024.101153
Zaamin B. Hussain, Eric R. Wagner
{"title":"Revolutionizing Shoulder Arthroplasty: The Transformative Impact of Extended Reality, Robotics, and Artificial Intelligence on Training, Planning, and Execution","authors":"Zaamin B. Hussain,&nbsp;Eric R. Wagner","doi":"10.1016/j.oto.2024.101153","DOIUrl":"10.1016/j.oto.2024.101153","url":null,"abstract":"<div><div>Technological innovations in shoulder arthroplasty could play a major role in addressing problems of implant positioning, stability, and longevity and optimizing patient outcomes. This review discusses the role of extended reality, navigation, patient-specific instrumentation, robotics and artificial intelligence and their applications in training, preoperative planning and intraoperative execution. These nascent technologies have the potential to deliver extraordinary value to patients requiring shoulder arthroplasty but long-term prospective clinical data justifying their mainstream use is currently lacking.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101153"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743188","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}
引用次数: 0
Shoulder Arthroplasty
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1016/j.oto.2024.101154
Jonathan D. Hughes
{"title":"Shoulder Arthroplasty","authors":"Jonathan D. Hughes","doi":"10.1016/j.oto.2024.101154","DOIUrl":"10.1016/j.oto.2024.101154","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101154"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743183","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}
引用次数: 0
Contributors (pick up from previous issue w/updates)
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1053/S1048-6666(24)00069-7
{"title":"Contributors (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1048-6666(24)00069-7","DOIUrl":"10.1053/S1048-6666(24)00069-7","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101160"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743182","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}
引用次数: 0
Reverse Shoulder Arthroplasty: History, Indications, Design, Outcomes, and Complications
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1016/j.oto.2024.101149
J. Austin Stratton BS, Steve H. Bayer MD, Justin W. Arner MD
{"title":"Reverse Shoulder Arthroplasty: History, Indications, Design, Outcomes, and Complications","authors":"J. Austin Stratton BS,&nbsp;Steve H. Bayer MD,&nbsp;Justin W. Arner MD","doi":"10.1016/j.oto.2024.101149","DOIUrl":"10.1016/j.oto.2024.101149","url":null,"abstract":"<div><div>The reverse total shoulder arthroplasty (rTSA) has become an increasingly common procedure with rapidly expanding indications. The purpose of this review is to summarize the history of the rTSA, provide an overview of modern implant design, and discuss the expanding indications for primary rTSA, rTSA in the revision setting, and the associated outcomes. The Grammont rTSA was introduced in 1985 for the treatment of cuff tear arthroplasty (CTA). Due to complications including scapular notching, stress fracture of the acromion and scapular spine, and instability, subsequent iterations have included glenoid component lateralization, changes in glenoid baseplate positioning, variations in humeral neck shaft angle, and inlay vs onlay humeral component design. Modernization of the rTSA design has resulted in expanding indications beyond CTA, including irreparable cuff tear, primary osteoarthritis, and fracture. Modern rTSA designs have demonstrated improvement in patient reported outcomes and pain from preoperative baseline with high patient satisfaction. However, rates of scapular notching increase over time and functional outcomes remain limited by deficits in range of motion, especially with internal rotation. An ideal implant configuration has not been identified, but navigation and extended reality are emerging areas of study that may improve implant placement and patient outcomes.</div></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101149"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743186","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
Table of Contents (pick up from previous issue w/updates)
IF 0.2
Operative Techniques in Orthopaedics Pub Date : 2024-12-01 DOI: 10.1053/S1048-6666(24)00068-5
{"title":"Table of Contents (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1048-6666(24)00068-5","DOIUrl":"10.1053/S1048-6666(24)00068-5","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":"34 4","pages":"Article 101159"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743181","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}
引用次数: 0
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