Journal of shoulder and elbow arthroplasty最新文献

{"title":"Stemless RTSA","authors":"C. Witney-Lagen, P. Consigliere, L. Natera, Ofer Levy","doi":"10.1007/978-3-030-19285-3_12","DOIUrl":"https://doi.org/10.1007/978-3-030-19285-3_12","url":null,"abstract":"","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73101470","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":"Reverse Shoulder Arthroplasty for B2 Glenoid Deformity.","authors":"Andrew M Holt,&nbsp;Thomas W Throckmorton","doi":"10.1177/2471549219897661","DOIUrl":"https://doi.org/10.1177/2471549219897661","url":null,"abstract":"<p><p>In shoulder osteoarthritis, the B2 glenoid presents challenges in treatment because of the excessive retroversion and posterior deficiency of the glenoid. Correction of retroversion and maintenance of a stable joint line with well-fixed implants are essential for the successful treatment of this deformity with arthroplasty. Reverse shoulder arthroplasty offers several key advantages in achieving this goal, including favorable biomechanics, a well-fixed baseplate, and proven success in other applications. Techniques such as eccentric reaming, bone grafting, and baseplate augmentation allow surgeons to tailor treatment to the patient's altered anatomy. Eccentric reaming is favored for correction of small defects or mild version anomalies. Current trends favor bone grafting for larger corrections, though augmented components have shown early promise with the potential for expanded use. With overall promising results reported in the literature, reverse shoulder arthroplasty is a useful tool for treating older patients with B2 glenoid deformities.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219897661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39396533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Point-Based Model to Predict Absolute Risk of Revision in Anatomic Shoulder Arthroplasty.","authors":"Peter Lc Lapner,&nbsp;Meaghan D Rollins,&nbsp;Meltem G Tuna,&nbsp;Caleb Netting,&nbsp;Anan Bader Eddeen,&nbsp;Carl van Walraven","doi":"10.1177/2471549219883446","DOIUrl":"https://doi.org/10.1177/2471549219883446","url":null,"abstract":"<p><strong>Background: </strong>Total shoulder arthroplasty (TSA) has demonstrated good long-term survivorship but early implant failure can occur. This study identified factors associated with shoulder arthroplasty revision and constructed a risk score for revision surgery following shoulder arthroplasty.</p><p><strong>Methods: </strong>A validated algorithm was used to identify all patients who underwent anatomic TSA between 2002 and 2012 using population-based data. Demographic variables included shoulder implant type, age and sex, Charlson comorbidity score, income quintile, diagnosis, and surgeon arthroplasty volume. The associations of covariates with time to revision were measured while treating death as a competing risk and were expressed in the Shoulder Arthroplasty Revision Risk Score (SARRS).</p><p><strong>Results: </strong>During the study period, 4079 patients underwent TSA. Revision risk decreased in a nonlinear fashion as patients aged and in the absence of osteoarthritis with no influence from surgery type or other covariables. The SARRS ranged from -21 points (5-year revision risk 0.75%) to 30 points (risk 11.4%). Score discrimination was relatively weak 0.55 (95% confidence interval: 0.530.61) but calibration was very good with a test statistic of 5.77 (<i>df</i> = 8, <i>P</i> = .762).</p><p><strong>Discussion: </strong>The SARRS model accurately predicted the 5-year revision risk in patients undergoing TSA. Validation studies are required before this score can be used clinically to predict revision risk. Further study is needed to determine if the addition of detailed clinical data including functional outcome measures and the severity of glenohumeral arthrosis increases the model's discrimination.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219883446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39396532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shoulder Arthroplasty for Posttraumatic Arthritis Is Associated With Increased Transfusions and Longer Operative Times","authors":"Tyler A. Luthringer, Benjamin S. Kester, Oluwadamilola Kolade, M. Virk, M. Alaia, K. Campbell","doi":"10.1177/2471549219882133","DOIUrl":"https://doi.org/10.1177/2471549219882133","url":null,"abstract":"Introduction: Posttraumatic arthritis (PTA) is a common sequela of proximal humerus fractures that is commonly managed with anatomic or reverse total shoulder arthroplasty (TSA). TSA for PTA is more challenging than that performed for primary osteoarthritis and frequently leads to worse patient outcomes. CPT uniformly classifies all cases of primary TSA, irrespective of procedural complexity and resource utilization. This study analyzes intraoperative differences and 30-day outcomes for anatomic and reverse TSA performed in the posttraumatic shoulder. Methods: Patients undergoing TSA from 2008 to 2015 were selected from the National Surgical Quality Improvement Program database and stratified according to concurrent procedures and administrative codes indicating posttraumatic diagnoses. Perioperative parameters and 30-day complications were recorded; multivariate analyses were performed to determine whether PTA was a risk factor for poor outcomes. Results: A total of 8508 primary and 243 posttraumatic TSAs were identified. Posttraumatic TSA patients were slightly younger (P = .003), more likely to be female (P < .001), smokers (P = .029), and diabetic (P = .003). Diagnosis of PTA was an independent risk factor for prolonged operative times ≥160 minutes (≥1 standard deviation above the mean, P = .003; odds ratio [OR]: 1.718; 95% confidence interval [CI]: 1.204–2.449) and increased bleeding requiring transfusion (P < .001; OR: 2.719; 95% CI: 1.607–4.600). Although posttraumatic TSA had a tendency for longer hospital admissions, 30-day readmissions were not significantly different between cohorts. Conclusions: Compared with primary osteoarthritis, a preoperative diagnosis of PTA is an independent risk factor for prolonged operative times and postoperative transfusion in anatomic or reverse TSA patients; such patients may be less than optimal candidates for same-day discharges or outpatient shoulder arthroplasty.","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219882133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45237293","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":"Total Elbow Arthroplasty in Rheumatoid Arthritis and Other Inflammatory Conditions: Unlinked or Linked Replacement?","authors":"A. Colozza, L. Perna, A. Trimarchi, B. Morrey","doi":"10.1007/978-3-030-14455-5_9","DOIUrl":"https://doi.org/10.1007/978-3-030-14455-5_9","url":null,"abstract":"","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89968640","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 Augmented Glenoid Implants for the Management of the B2 Glenoid.","authors":"Lisa Gm Friedman,&nbsp;Grant E Garrigues","doi":"10.1177/2471549219870350","DOIUrl":"https://doi.org/10.1177/2471549219870350","url":null,"abstract":"<p><p>The B2 glenoid is defined by Walch et al. as a glenoid that is biconcave with posterior erosion accompanied by posterior humeral head subluxation. This creates unique challenges for the treating orthopedic surgeon. Bone loss, excessive retroversion, and posterior subluxation make anatomic shoulder arthroplasty in this setting fraught with increased complications, including instability, glenoid component loosening, and poor clinical outcomes. Many techniques have been devised to treat the arthritic shoulder with a B2 glenoid, including hemiarthroplasty, total shoulder arthroplasty using eccentric reaming, bone grafting and custom implantation, and reverse total shoulder arthroplasty. In this review, we will focus on anatomic total shoulder arthroplasty using augmented glenoid implants to treat the B2 glenoid. Indications, clinical results, and basic science analyses of augmented anatomic glenoids are also discussed.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219870350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39396531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elbow Arthrodesis—A Review","authors":"S. Kamineni, Matthew E Eads, Rasesh Desai","doi":"10.1177/2471549219870347","DOIUrl":"https://doi.org/10.1177/2471549219870347","url":null,"abstract":"Elbow arthrodesis is an uncommonly performed operation, but it has a specific and niche place in the management of difficult elbow pathology. Many indications and contraindications have been reported, but one of the more challenging aspects of this procedure remains choosing the appropriate angle of fusion. Varying results have been reported along with speculations as to why the fusion may not have been obtained, such as lack of bony structure in the site. Common complications have also been reported most notably fractures distal to the plate. One area of future research is that of the reversibility of this procedure; going from a total elbow arthroplasty to an elbow arthrodesis has been studied well but not so for converting an arthrodesis to an arthroplasty. Elbow arthrodesis remains a valuable but niche solution for complex elbow pathologies that cannot be addressed with other commoner elbow operations.","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219870347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45306137","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":"Eccentric Reaming for B2 Glenoids: History, Preoperative Planning, Surgical Technique, and Outcome.","authors":"Matthew J Smith,&nbsp;Christopher M Loftis,&nbsp;Nathan W Skelley","doi":"10.1177/2471549219870348","DOIUrl":"https://doi.org/10.1177/2471549219870348","url":null,"abstract":"<p><strong>Background: </strong>The biconcave (B2) glenoid is characterized by preservation of the anterior portion of the native glenoid with asymmetric wear of the posterior glenoid. Surgical options for glenoid correction have evolved. The goal of shoulder arthroplasty is to place the implants in such a manner to return the humeral head to a centered position and restore the joint line to a neutral position. There is no current consensus on method of treatment and correction.</p><p><strong>Methods: </strong>The current and historical literature on total shoulder arthroplasty was used to examine technique viability.</p><p><strong>Results: </strong>Asymmetric remaining can be used to address up to 15° of version correction without compromise of cortical bone. It is important to have the proper presurgical planning, to understand the limitations of correction, and to have other options available to treat the biconcave glenoid.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219870348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39412600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autografting for B2 Glenoids.","authors":"Siddhant K Mehta,&nbsp;Jay D Keener","doi":"10.1177/2471549219865786","DOIUrl":"https://doi.org/10.1177/2471549219865786","url":null,"abstract":"<p><p>The Walch B2 glenoid is characterized by a biconcave glenoid deformity, acquired glenoid retroversion, and posterior subluxation of the humeral head. Surgical reconstruction of the B2 glenoid is often challenging due to the complexity of the deformity. Bone graft augmentation using humeral head autograft is a valuable adjunct to anatomic total shoulder arthroplasty in the B2 glenoid, particularly in the young, highly active patient with severe glenoid retroversion (>25°-30°). Although this technique affords the ability to correct glenoid version and simultaneously enhances glenoid bone stock, it is technically challenging. The potential for graft-related complications also exists, which may further impact glenoid implant longevity and functional outcome. This review article aims to describe the B2 glenoid morphology, discuss the challenges in managing the B2 deformity, and provide further insight specifically regarding autografting at the time of anatomic total shoulder arthroplasty for reconstruction of the B2 glenoid.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219865786","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39397568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Radiological Evaluation of Subscapular Suture Integrity in Reverse Shoulder Arthroplasty.","authors":"Alexandre Almeida,&nbsp;Daniel C Agostini,&nbsp;Cristiano Raymondi,&nbsp;Pedro Guarise,&nbsp;Nayvaldo Couto de Almeida,&nbsp;Guilherme A Stangherlini","doi":"10.1177/2471549219861185","DOIUrl":"https://doi.org/10.1177/2471549219861185","url":null,"abstract":"<p><strong>Objective: </strong>The aim was to establish a correlation between the integrity of a suture made in the subscapular tendon (SST), as assessed by an ultrasound examination, and its functionality, as assessed by clinical tests during the postoperative period following reverse shoulder arthroplasty (RSA). A secondary goal is to evaluate the presence and viability of the sutured SST.</p><p><strong>Methods: </strong>This is a retrospective study of 18 RSA patients in whom the SST was repositioned to the anterior face of the humeral osteotomy. The median time of the postoperative evaluation was 31 months. The clinical evaluation consisted of the Gerber lift-off test, the internal rotation (IR) lag sign test, and the abdominal compression test, as well as forward flexion (FF), external rotation (ER), and IR. All patients underwent shoulder ultrasounds to evaluate the SST presence and viability.</p><p><strong>Results: </strong>The SST was visualized in 13 patients (72.2%; 95% confidence interval [CI], 51.5-92.9). Of these 13 patients, the SST presented an altered fibrillar pattern in 5 patients (38.4%; 95% CI, 12.0-64.9) and was considered nonviable. There were no associations between SST viability and a positive Gerber's lift-off test (<i>P</i> = .480), a positive IR lag sign test (<i>P</i> = .480), or a positive abdominal compression test (<i>P</i> = .618). There were no significant differences in FF (<i>P</i> = .104), ER (<i>P</i> = .196), or IR (<i>P</i> = .374) mobility between patients with viable SSTs and those without viable SSTs.</p><p><strong>Conclusion: </strong>It was not possible to demonstrate a correlation between the integrity of the SST repair based on the ultrasound and its functionality as assessed by clinical tests in the postoperative period following an RSA. The SST repair has a high failure rate, as demonstrated by the high incidence of nonviable or absent tendons.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2471549219861185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39397566","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}