Journal of shoulder and elbow arthroplasty最新文献

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Distal Clavicular Resection Worsens Outcomes in Rotator Cuff Repair: A National Database Study. 锁骨远端切除术会降低肩袖修复的效果:一项国家数据库研究。
Journal of shoulder and elbow arthroplasty Pub Date : 2024-05-16 eCollection Date: 2024-01-01 DOI: 10.1177/24715492241249374
Joshua M Wiener, Parshva A Sanghvi, Kira A Smith, Andrew Moyal, Molly M Piper, Jacob G Calcei
{"title":"Distal Clavicular Resection Worsens Outcomes in Rotator Cuff Repair: A National Database Study.","authors":"Joshua M Wiener, Parshva A Sanghvi, Kira A Smith, Andrew Moyal, Molly M Piper, Jacob G Calcei","doi":"10.1177/24715492241249374","DOIUrl":"https://doi.org/10.1177/24715492241249374","url":null,"abstract":"<p><strong>Introduction: </strong>Distal clavicular resection (DCR) is a procedure used to alleviate acromioclavicular joint (ACJ) pain, often done alongside rotator cuff repair (RCR). This investigation explored the relationships between DCR and RCR, outcomes of DCR during RCR, and complication rates of DCR.</p><p><strong>Methods: </strong>This retrospective study used electronic medical record data from the TriNetX database. Cohorts were subdivided based on the timeline of DCR in comparison to RCR, as well as comparing RCR with DCR against RCR without DCR.</p><p><strong>Results: </strong>In total 46 534 patients underwent RCR with 14.8% (6898) of these patients also undergoing DCR. And 72.8% (5021) had DCR during RCR, and 10.7% (740) had DCR after RCR. Less than 5% (<10) of patients with preexisting ACJ pain required DCR 3 years postoperatively, and 0.002% (78) patients without ACJ pain developed ACJ pain within 3 years. Less that 20 patients underwent DCR within 3 years of being diagnosed with ACJ pain. Patients who had RCR with DCR were more likely to have chronic pain postoperatively (<i>P</i> < .0001).</p><p><strong>Conclusion: </strong>Patients undergoing RCR do not require subsequent DCR. Performing DCR does not offer significant benefit when compared to performing isolated RCR without DCR in patients with preexisting ACJ pain, but increases risk for ACJ instability and chronic pain.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492241249374"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960974","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
Restoring Functionality: Humeroradial Total Elbow Revision for Salvaging Total Elbow Arthroplasty Failure and Ulnar Bone Loss. 恢复功能: 挽救全肘关节成形术失败和尺骨缺失的肱骨侧全肘关节翻修术。
Journal of shoulder and elbow arthroplasty Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI: 10.1177/24715492241251927
Samuel Shepard, Naem A Mufarreh, Samuel J Shine, H Brent Bamberger
{"title":"Restoring Functionality: Humeroradial Total Elbow Revision for Salvaging Total Elbow Arthroplasty Failure and Ulnar Bone Loss.","authors":"Samuel Shepard, Naem A Mufarreh, Samuel J Shine, H Brent Bamberger","doi":"10.1177/24715492241251927","DOIUrl":"https://doi.org/10.1177/24715492241251927","url":null,"abstract":"<p><p>As the number of total elbow arthroplasty (TEA) continues to increase worldwide, one might predict the number of revision TEA would rise as well. The most common indications for revision TEA include (a) loosening, (b) infection, and (c) periprosthetic fracture. Although the rate of revision TEA procedures continues to rise due to the infrequency in which they are performed compared to other arthroplasty surgeries, no gold standard algorithm or procedure for managing severe ulnar bone loss in revision TEA has been determined. Various surgical techniques and strategies including allograft-prosthesis composite, custom long prosthesis with or without allograft, and resection arthroplasty have all been employed in attempting to address severe ulnar bone loss in revision TEA. Though the reported outcomes are mixed at best between each treatment strategy with similar complication rates. Another option is implanting the ulnar component into the radius. In those patients with severe ulnar bone loss, a humeroradial TEA revision can provide stability, restore range of motion, and provide pain relief.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492241251927"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872581","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
Modification of Humeral Component Results in Increased Impingement Free Range of Motion in a Reverse Shoulder Arthroplasty Model. 修改肱骨组件可增加反向肩关节成形术模型中的撞击自由活动范围。
Journal of shoulder and elbow arthroplasty Pub Date : 2024-04-15 eCollection Date: 2024-01-01 DOI: 10.1177/24715492241237034
Dalton Dale Schroeder, Alexander Borsgard, Timothy Lee Rossman, Cory Michael Stewart
{"title":"Modification of Humeral Component Results in Increased Impingement Free Range of Motion in a Reverse Shoulder Arthroplasty Model.","authors":"Dalton Dale Schroeder, Alexander Borsgard, Timothy Lee Rossman, Cory Michael Stewart","doi":"10.1177/24715492241237034","DOIUrl":"https://doi.org/10.1177/24715492241237034","url":null,"abstract":"<p><strong>Introduction: </strong>Shoulder arthroplasties have been demonstrated to provide reliable pain relief as well as functional benefits. The advent of the reverse shoulder arthroplasty allowed for expanded indications for shoulder replacement. Several studies comparing the outcomes of anatomic and reverse total shoulder arthroplasties have demonstrated decreased range of motion in the reverse arthroplasty cohort, especially in internal rotation. The authors hypothesized that slight modifications to the humeral component of a reverse shoulder arthroplasty could result in increased impingement free range of motion without significant sacrifices to stability.</p><p><strong>Methods: </strong>A reverse shoulder arthroplasty model was fashioned to mimic a setting of anterior mechanical impingement after replacement. Sequential resections were taken from the anterior aspect of the polyethylene up to a resection of 10 mm. A solid modeling software was utilized to compare the experimental group to the control group with regard to impingement free motion. Finite element analysis was subsequently utilized to assess stability of the construct in comparison to the nonmodified polyethylene.</p><p><strong>Results: </strong>Impingement free internal rotation increased minimally at 3 mm of resection but considerably at each further increase in resection. A resection of 10 mm resulted roughly 30% improvement in impingement free internal rotation. Instability in this model increased with modifications beyond 7 mm.</p><p><strong>Conclusion: </strong>Slight alterations to the geometry of the humeral tray and polyethene components can result in improvements in impingement-free internal rotation without substantial increased instability in this model. Further work is needed to determine in vivo implications of modifications to the humeral tray and polyethylene.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492241237034"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11020712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868632","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
Better Constant Scores and Active Forward Elevation Using Deltopectoral Versus Anterosuperior Approach for Reverse Shoulder Arthroplasty: Matched Cohort Study. 在反向肩关节置换术中采用胸骨下入路与前上入路可获得更好的恒定评分和主动前抬:匹配队列研究
Journal of shoulder and elbow arthroplasty Pub Date : 2024-03-01 eCollection Date: 2024-01-01 DOI: 10.1177/24715492241234178
Cecile Nerot, Julien Berhouet, Jérôme Garret, Jean Kany, Arnaud Godenèche
{"title":"Better Constant Scores and Active Forward Elevation Using Deltopectoral Versus Anterosuperior Approach for Reverse Shoulder Arthroplasty: Matched Cohort Study.","authors":"Cecile Nerot, Julien Berhouet, Jérôme Garret, Jean Kany, Arnaud Godenèche","doi":"10.1177/24715492241234178","DOIUrl":"10.1177/24715492241234178","url":null,"abstract":"<p><strong>Purpose: </strong>To determine, from a sizable cohort of reverse shoulder arthroplasty (RSA), whether the deltopectoral (DP) or anterosuperior (AS) approach grant better outcomes at a minimum follow-up of 24 months.</p><p><strong>Methods: </strong>The authors reviewed 743 RSAs in patients with primary osteoarthritis (OA) with or without rotator cuff lesions and secondary OA due to rotator cuff tears. The DP approach was used in 540 and the AS approach in 203. Pre- and post-operative constant scores (CSs) and shoulder range of motion were recorded.</p><p><strong>Results: </strong>Of the initial cohort of 743 shoulders, 193 (25.7%) were lost to follow-up, 16 (2.1%) died, and 33 (4.4%) were revised; 540 shoulders were operated using DP approach (73%), of which 22 were revised (4.1%), while 203 were operated using the AS approach (27%), of which 11 were revised (5.4%). Propensity score matching resulted in two groups: 172 shoulders operated by DP approach, and 88 shoulders operated by AS approach. Comparing outcomes of the matched groups at 2 or more years also revealed that, compared to the AS approach, the DP approach resulted in significantly better post-operative CSs (67.3 ± 14.0° vs 60.8 ± 18.3, <i>P</i> = 0.017), active forward elevation (137° ± 27.4° vs 129° ± 29.8; <i>P</i> = 0.031).</p><p><strong>Conclusion: </strong>At 2 or more years following RSA, the DP approach granted significantly better CS (by 6.5 points) and active forward elevation (by 8°) compared to the AS approach. The differences observed are clinically relevant and must be considered to manage patient expectations following RSA and for selecting surgical approach depending on their functional needs.</p><p><strong>Level of evidence: </strong>III, comparative study.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492241234178"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023603","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
Reverse and Anatomic Shoulder Arthroplasty Regional Usage and Open Payment Analysis Using the Centers for Medicare and Medicaid Services Database. 利用医疗保险和医疗补助服务中心数据库对反向和解剖肩关节置换术的地区使用情况和公开支付情况进行分析。
Journal of shoulder and elbow arthroplasty Pub Date : 2024-02-11 eCollection Date: 2024-01-01 DOI: 10.1177/24715492231207278
David J Haddad, Omar H Rizvi, Nathan C Sherman, Abigail R Hamilton
{"title":"Reverse and Anatomic Shoulder Arthroplasty Regional Usage and Open Payment Analysis Using the Centers for Medicare and Medicaid Services Database.","authors":"David J Haddad, Omar H Rizvi, Nathan C Sherman, Abigail R Hamilton","doi":"10.1177/24715492231207278","DOIUrl":"10.1177/24715492231207278","url":null,"abstract":"<p><strong>Background: </strong>This retrospective review aimed to assess if open payments made by industry arthroplasty companies to physicians and hospital systems were significantly affected by implant type and geographic variation.</p><p><strong>Methods: </strong>Data was obtained from the Centers for Medicare and Medicaid Services (CMS) publicly available open payment datasets (2016-2019). Geographic locations were identified using regions as defined by the US Census Bureau. A linear regression was calculated to predict the open payment made based on the created variable region, the most used implant type (reverse vs anatomic, n > 30 to be included), and their hypothesized interaction.</p><p><strong>Results: </strong>A significant regression equation was found for the hypothesized interaction between implant and region, <i>F</i><sub>(13,11 186)</sub> = 3.446, <i>P </i>< .0001, with an <i>R</i><sup>2</sup> of 0.005. Within the regression, the implant type alone was not significantly related to the open payment (<i>P </i>= .070) but only became significant when paired with the region in the South (US$5807; <i>P </i>< .0001) and West (US$5638; <i>P </i>= .0012) compared to the Northeast.</p><p><strong>Discussion: </strong>Our multivariate linear regression model revealed that reverse total shoulder implants were associated with higher open payments, but only within the South and West regions. This indicates that the contributions made by industry arthroplasty companies are a function of both implant and region.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492231207278"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10860377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725119","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
Is the Number of Citations Related to the Study Methodology in Shoulder Arthroplasty Literature? A Bibliometric and Statistical Analysis of Current Evidence. 肩关节置换术文献中的引用次数与研究方法有关吗?当前证据的文献计量与统计分析》。
Journal of shoulder and elbow arthroplasty Pub Date : 2024-01-05 eCollection Date: 2024-01-01 DOI: 10.1177/24715492231223346
Roberto de Giovanni, Amedeo Guarino, Valentina Rossi, Dario Bruzzese, Massimo Mariconda, Andrea Cozzolino
{"title":"Is the Number of Citations Related to the Study Methodology in Shoulder Arthroplasty Literature? A Bibliometric and Statistical Analysis of Current Evidence.","authors":"Roberto de Giovanni, Amedeo Guarino, Valentina Rossi, Dario Bruzzese, Massimo Mariconda, Andrea Cozzolino","doi":"10.1177/24715492231223346","DOIUrl":"10.1177/24715492231223346","url":null,"abstract":"<p><strong>Background: </strong>We reviewed the shoulder arthroplasty (SA) literature to correlate citations, methodological characteristics and quality of most-cited articles in this field. We hypothesized that a greater number of citations would be found for high-quality clinical studies.</p><p><strong>Methods: </strong>We searched the Web of Knowledge database for the 50 most-cited articles about SA and collected author name, publication year, country of origin, journal, article type, level of evidence (LoE), subject of paper, type of arthroplasty and metrics (number of citations and citation rate). Coleman Methodology Score (CMS) was computed for clinical articles. Statistical analysis of variance and correlation coefficients were used to investigate the relationship between different variables.</p><p><strong>Results: </strong>Out of the selected 50 studies on SA, 26% were nonclinical. There were 15,393 citations overall (mean 307.8), with a mean 19.5 citations per year (range 48.3-6.7). Thirty or 60% of all articles were LoE IV. All studies were published between 1984 and 2011 in 8 journals. Reverse SA (RSA) was the most common subject (36% of studies). The United States was the country responsible for most contributions (50% of studies). CMS ranged from 81 to 38 (mean 59.6). RSA received the highest number of citations (<i>P</i> < .001), independently from country of origin (<i>P</i> = .137) and LoE (<i>P</i> = .723). CMS correlated with citation rate (<i>r</i> = 0.397; <i>P</i> = .013) and publication year (tau = 0.397; <i>P</i> = .013), but not with LoE (<i>P</i> = .204).</p><p><strong>Conclusion: </strong>In SA literature, citation rate positively correlates with methodological quality of a study, independently from publication country and LoE. Among most-cited papers, RSA is the most common standalone subject.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492231223346"},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378944","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
Greater Mental Health Burden is Associated With Poor Postoperative Pain Control and Increased Opioid Utilization Following Total Shoulder Arthroplasty. 全肩关节置换术后疼痛控制不佳和阿片类药物使用量增加与心理健康负担加重有关。
Journal of shoulder and elbow arthroplasty Pub Date : 2024-01-05 eCollection Date: 2024-01-01 DOI: 10.1177/24715492231223665
Alexander J MacFarlane, Benjamin Ritter, Joshua Uffer, Lin Feng, Alexa Streicher, Mohammad N Haider, Thomas R Duquin
{"title":"Greater Mental Health Burden is Associated With Poor Postoperative Pain Control and Increased Opioid Utilization Following Total Shoulder Arthroplasty.","authors":"Alexander J MacFarlane, Benjamin Ritter, Joshua Uffer, Lin Feng, Alexa Streicher, Mohammad N Haider, Thomas R Duquin","doi":"10.1177/24715492231223665","DOIUrl":"10.1177/24715492231223665","url":null,"abstract":"<p><strong>Background: </strong>Prolonged opioid use is associated with higher complications and worse patient-reported outcomes following total shoulder arthroplasty (TSA). Identified risk factors for prolonged postoperative use are related to several medical comorbidities, gender, diagnoses of anxiety or depressive disorders, and preoperative opioid use. In this study, we hypothesized that patient-reported mental health characteristics can help to identify patients at risk of worse postoperative pain control, worse sleep, and higher opioid utilization following TSA.</p><p><strong>Methods: </strong>Ninety-three consecutive patients were asked to fill out 2 mental health questionnaires prior to undergoing TSA. Following surgery, patients filled out a daily pain diary to track their daily pain, pain medication use, and quality and duration of their sleep for 30 days. Preoperative opioid use and postoperative refill were determined by the New York State Prescription Monitoring Program. Mixed-model linear regressions were conducted. Significance was defined as <i>p</i> < 0.05.</p><p><strong>Results: </strong>Postoperative opioid refill was associated with female gender, preoperative opioid therapy, higher inpatient opioid use, worse anxiety, depression, somatization, and pain catastrophizing scores. The number of days using opioids postoperatively was associated with worse pain catastrophizing scale (PCS) and somatization scores (patient health questionnaire-15). Preoperative opioid therapy was associated with worse somatization scores, whereas no opioids used after surgery were associated with better somatization scores. Worse sleep quality and duration were associated with worse PCS scores.</p><p><strong>Conclusion: </strong>A greater mental health burden is associated with worse postoperative pain control and higher opioid utilization during the acute postoperative period. This is especially evident in the pain catastrophizing and somatization domains.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492231223665"},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378943","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
Custom-made Glenoid Baseplate and Intra-Operative Navigation in Complex Revision Reverse Shoulder Arthroplasty: A Case Report. 定制盂基板和术中导航在复杂翻修反向肩关节置换术中的应用:病例报告。
Journal of shoulder and elbow arthroplasty Pub Date : 2024-01-05 eCollection Date: 2024-01-01 DOI: 10.1177/24715492231218183
Giacomo Peri, Elisa Troiano, Giovanni Battista Colasanti, Nicola Mondanelli, Stefano Giannotti
{"title":"Custom-made Glenoid Baseplate and Intra-Operative Navigation in Complex Revision Reverse Shoulder Arthroplasty: A Case Report.","authors":"Giacomo Peri, Elisa Troiano, Giovanni Battista Colasanti, Nicola Mondanelli, Stefano Giannotti","doi":"10.1177/24715492231218183","DOIUrl":"10.1177/24715492231218183","url":null,"abstract":"<p><p>Prosthetic instability is one of the most challenging complications to manage when considering reverse shoulder arthroplasty (RSA). Additional tools are available to improve accuracy in planning and execution of arthroplasties, such as 3-dimensional (3D) virtual planning based on computer tomography (CT) scan and intra-operative navigation. We report a case of an 84-year-old male treated for RSA prosthetic instability combined with severe glenoid deformity and bone loss, and subclinical periprosthetic joint infection (PJI). The definitive surgery consisted in implanting a customized metaglene component realized on the basis of the bone defect detected in the 3D-CT scan and implanted with the aid of computer-assisted intra-operative navigation. The patient was periodically followed-up for a year with clinical and radiological evaluations with the absence of further prosthetic dislocations nor PJI, a good overall satisfaction, a satisfying range of motion, and acceptable functional scores (American Shoulder and Elbow Surgeons Score 62, Constant-Murley Score 36). This is the first description, to our knowledge, of a customized glenoid baseplate implanted with the aid of intraoperative navigation. The combined use of 3D-CT planning and intra-operative computer-assisted navigation allows to manage complex cases of prosthetic revision surgery even where extensive bone defects are present.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"8 ","pages":"24715492231218183"},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379125","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
The Use of an External Cutting Guide for Patient-Specific Bone Grafting in Reverse Total Shoulder Arthroplasty: A Novel Technique. 在反向全肩关节成形术中使用外切导板进行患者特异性骨移植:一项新技术
Journal of shoulder and elbow arthroplasty Pub Date : 2023-12-11 eCollection Date: 2023-01-01 DOI: 10.1177/24715492231219566
Graeme T Harding, Aaron J Bois, Joseph T Cavanagh, Martin J Bouliane
{"title":"The Use of an External Cutting Guide for Patient-Specific Bone Grafting in Reverse Total Shoulder Arthroplasty: A Novel Technique.","authors":"Graeme T Harding, Aaron J Bois, Joseph T Cavanagh, Martin J Bouliane","doi":"10.1177/24715492231219566","DOIUrl":"https://doi.org/10.1177/24715492231219566","url":null,"abstract":"<p><p>Glenoid bone loss remains a substantial challenge in reverse shoulder arthroplasty and failure to address such bone loss may lead to implant malpositioning, instability and/or premature baseplate loosening. Currently, management of glenoid bone loss can be achieved by metal augmentation or bone grafting (ie, autograft or allograft). At the present time, options for creating and shaping glenoid bone grafts include free-hand techniques and simple reusable cutting guides that create the graft at a standard shape/angle. To our knowledge, there is no external guide available that enables surgeons to accurately prepare the bone graft to the desired dimensions/shape (ie, trapezoid or biplanar) to correct the glenoid deformity. In this article, we present a novel surgical technique that utilizes an external guide for creating a patient-specific bone graft to address glenoid deformity in the setting of reverse total shoulder arthroplasty.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"7 ","pages":"24715492231219566"},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10722917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809765","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
Primary Total Shoulder Arthroplasty is Superior to Hemiarthroplasty for the Treatment of Glenohumeral Arthritis: Analysis of 5-year Outcomes in a Large Surgical Database. 初次全肩关节置换术治疗肩关节炎优于半关节置换术:大型外科数据库中5年疗效分析。
Journal of shoulder and elbow arthroplasty Pub Date : 2023-10-20 eCollection Date: 2023-01-01 DOI: 10.1177/24715492231207482
Jason Long, Kunal Varshenya, Kier Blevins, Julia Ralph, Anna Bryniarski, Caroline Park, Lucy Meyer, Brian Lau
{"title":"Primary Total Shoulder Arthroplasty is Superior to Hemiarthroplasty for the Treatment of Glenohumeral Arthritis: Analysis of 5-year Outcomes in a Large Surgical Database.","authors":"Jason Long,&nbsp;Kunal Varshenya,&nbsp;Kier Blevins,&nbsp;Julia Ralph,&nbsp;Anna Bryniarski,&nbsp;Caroline Park,&nbsp;Lucy Meyer,&nbsp;Brian Lau","doi":"10.1177/24715492231207482","DOIUrl":"10.1177/24715492231207482","url":null,"abstract":"<p><strong>Background: </strong>Total shoulder arthroplasty (TSA) is the preferred treatment for glenohumeral arthritis refractory to nonoperative measures. However, some surgeons have argued for a role for hemiarthroplasty (HA) in the setting of a smooth glenoid that articulates appropriately with the humeral head. The purpose of this study is to evaluate long-term revision rates and short-term postoperative complications in patients undergoing either HA or TSA for glenohumeral arthritis.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent HA and TSA was conducted using a commercially available national database. Demographics, postoperative complications, risk factors, revision rates, and costs were analyzed using 2 sample <i>t</i>-tests, chi-squared tests, and multivariate logistic regressions.</p><p><strong>Results: </strong>Patients were stratified by operation: (1) HA (n = 1615) or 2) TSA (n = 7845). Patients undergoing primary TSA had higher rates of prior ipsilateral rotator cuff repair and corticosteroid injections. At 2 years, patients who underwent HA, 3.0% of patients had revision surgery, compared to 1.6% of patients who underwent TSA (<i>P</i> = .002); at 5 years, 3.7% of the HA cohort (<i>P</i> < .0001) had revision surgery, compared to 1.9% of patients who underwent TSA.</p><p><strong>Conclusions: </strong>Patients undergoing TSA or RTSA for glenohumeral arthritis had higher preoperative co-morbidities but had no difference in short-term complication rates with a lower risk of revision surgery at both 2-year and 5-year follow-up when compared to HA. Increasing age, female sex, hyperlipidemia, postoperative infection, shoulder instability, and thromboembolism all independently increased odds for revision shoulder arthroplasty for glenohumeral arthritis.</p><p><strong>Level of evidence level: </strong>III.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"7 ","pages":"24715492231207482"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/03/10.1177_24715492231207482.PMC10590041.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694888","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}
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