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Revision total shoulder arthroplasty for the treatment of glenoid arthrosis.

The development of painful glenoid arthrosis is the most common reason for reoperation after replacement of the humeral head. We performed twenty-two revision total shoulder arthroplasties, between 1983 and 1992, for the treatment of painful glenoid arthrosis in shoulders that had a prosthetic replacement of the humeral head. Eighteen shoulders (seventeen patients) were included in the study as their preoperative and operative records were complete and they had been followed for at least two years (mean, 5.5 years; range, 2.3 to 10.0 years). The indications for the hemiarthroplasty were trauma

The application of the limited contact dynamic compression plate in the upper extremity: an analysis of 114 consecutive cases.

We sought to assess the clinical effectiveness of a new plate design which offers improved biological and biomechanical features, the limited contact dynamic compression (LCDC) plate. We analysed 114 LCDC plates applied consecutively for upper extremity fractures or reconstruction in 94 patients. Three patients were lost to follow-up, leaving 111 plates in 91 patients followed to definitive fracture/osteotomy outcome. Thirty-seven plates were applied for reconstruction in 35 patients, including 11 where standard implants had failed. Fifty-six patients had 74 plates applied for acute fractures

Surgical treatment of arthritis in the elderly.

Arthritis in the elderly can be very effectively treated by a combination of careful orthopaedic and rheumatological assessment. The overall functional assessment, and definition of the aims and likely results of surgical treatment by the team approach, involving occupational therapists, physiotherapists and social workers, are important for success. There are many worthwhile surgical procedures available to relieve pain, and restore mobility and independence to those affected by osteoarthritis and rheumatoid arthritis.

Zone-specific bone density evaluation of the acromion may predict postoperative acromion stress fracture in patients undergoing a reverse total shoulder arthroplasty.

BACKGROUND: The goal of this study was to use preoperative computed tomography (CT) scans to identify differences in the Hounsfield units (HU) of the acromion in patients who did and did not develop a postoperative acromial and scapular spine fracture (ASF) after primary reverse total shoulder arthroplasty (rTSA). METHODS: A retrospective analysis was performed at a single institution. All patients undergoing an rTSA with either a 135° neck-shaft angle (NSA) humeral inlay design combined with a lateralized center-of-rotation (COR) glenosphere or a 145° NSA onlay combined with a medialized COR

Results of latissimus dorsi tendon transfer for irreparable cuff tears.

Rupture of the supraspinatus and infraspinatus tendon (and teres minor) can cause loss of active external rotation (ER), entailing severe functional disability in daily activities. Latissimus dorsi tendon transfer (LDTT), proposed by Gerber in 1988, appears to be the best adapted solution in these cases of irreparable posterior and superior cuff tears. Between 2001 and 2004, 30 patients were operated on by the technique described by Gerber, with the transfer fixed anteriorly to the subscapularis tendon and laterally to the greater tuberosity by transosseous suture. One patient, subsequently re

Fulfillment of patients' expectations for reverse total shoulder arthroplasty for the treatment of rotator cuff tear arthropathy using the Exactech Equinoxe Platform.

BACKGROUND: Despite the increasing use of reverse total shoulder arthroplasty (rTSA), there remain limited data regarding perioperative expectations and fulfillment of expectations for patients undergoing rTSA for rotator cuff tear arthropathy (CTA). Thus, the purpose of this study was to determine the proportion of expectations that are fulfilled following rTSA and to determine which patient characteristics are associated with fulfillment of expectations at 2-year follow-up. METHODS: Preoperatively, patients completed the Hospital for Special Surgery's Shoulder Surgery Expectation Survey, Am

Primary partial humeral head resurfacing: outcomes with the HemiCAP implant.

BACKGROUND: Humeral head defects such as degenerative disease or avascular necrosis are often treated with stemmed hemiarthroplasty or total shoulder arthroplasty. Despite its historical and clinical significance, stemmed humeral head replacement poses inherent technical challenges to placing spherical implants at the anatomically correct head height, version, and neck-shaft angle. PURPOSE: The aim of this study was to assess humeral head inlay arthroplasty as a joint-preserving alternative that maintains the individual head-neck-shaft anatomy. Humeral head inlay arthroplasty also allows intr

Functional and Rehabilitative Outcomes of Patients Affected by Bone Cancer of the Upper Limb Treated with MUTARS Prosthesis: A Narrative Review.

Megaprostheses are well-known, reliable, and effective reconstruction prostheses used in oncologic surgery for limb salvage in patients affected by primary or metastatic bone tumors. Rehabilitation plays a major role after MUTARS replacement, with the aim of improving function after surgery and maintaining the highest possible quality of life. Only a few studies have been published about the use of megaprostheses for the upper limb. The aim of this narrative review is to describe the results of functional and rehabilitative outcomes of patients affected by bone primary or metastatic bone cance

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… prosthesis for the treatment of proximal humerus tumors [ 33 ]. … Neer Award 2005: The Grammont reverse shoulder prosthesis: Results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J. Shoulder Elbow. Surg. 2006;15:527–540. doi: 10.1016/j.jse.2006.01.003. 32. Hage W.D., Aboulafia A.J., Aboulafia D.M. …

The survival, mechanisms of failure, and function after total humeral replacement in patients with primary sarcomas.

BACKGROUND: Total humeral replacement (THR) is one of the few options for reconstruction when the humerus is extensively involved or with skip lesions. However, there are few studies focusing on the long-term outcomes of THR for primary sarcomas, and the function and endoprosthesis survival remains uncertain. QUESTIONS/PURPOSES: The purposes of this study were to answer the following questions: (1) What are the oncological and functional outcomes of THR? (2) What are the overall survival (OS) and revision-free survival rates of THR? (3) What are the failure mechanisms of THR? METHODS: A retr

Subacromial morphometric assessment of the clavicle hook plate.

BACKGROUND: Clavicle hook plates are an effective plate fixation alternative for distal clavicle fractures and severe acromioclavicular joint dislocations. However, post-operative complications associated with the subacromial portion of the hook include acromial osteolysis and subacromial impingement. We examine and quantify the three-dimensional position of the subacromial portion of the hook plate relative to surrounding acromial and subacromial structures in a series of cadaveric shoulders to determine if hook positioning predisposes the shoulder to these noted post-operative complications.

UCLA Conference. Diagnosis and treatment of erosive rheumatoid arthritis and other forms of joint destruction.

Single or multiple destruction of joints arises from many causes, ranging from the acute destructive process (usually monarticular) in septic joint disease to the chronic, slowly evolving destruction of cartilage and adjacent bone that occurs in osteoarthritis. Medical treatment of a few of these conditions (including rheumatoid arthritis) is reasonably satisfactory if it is initiated early. On the other hand, surgical procedures are indicated if physical and X-ray examination of the involved joints discloses the presence of a significant destructive process involving both articular cartilage

Endoprosthetic Reconstruction of the Proximal Humerus with an Inverse Tumor Prosthesis

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… Results of an inverted shoulder prosthesis after resection for tumor of the proximal humerus Rev. Chir. Orthop. Reparatrice Appar. Mot. 2002 88 373 378 12124537 14. Zumstein M.A. Pinedo M. Old J. Boileau P. …

Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer.

BACKGROUND: We report our experience in treating infected shoulder arthroplasty and primary shoulder sepsis using a commercially produced antibiotic-impregnated cement spacer. MATERIALS AND METHODS: We treated 16 shoulders in 15 patients for infected arthroplasty or osteomyelitis of the proximal humerus with irrigation and débridement, hardware removal, or humeral head resection, or both, and placement of an interval articulating hemiarthroplasty with a commercially made gentamicin-impregnated cement spacer. RESULTS: Mean follow-up was 20.5 months after spacer placement. At the time of débri

Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation.

PURPOSE: The purpose of this study was to consider the indications and evaluate the clinical advantages and disadvantages including, results and complications, of immediate reconstruction using a latissimus dorsi (LD) free flap and reconstruction plate (R-plate) in advanced oro-mandibular tumour resection. METHODS AND MATERIALS: Our cohort included 116 patients who underwent LD free flap and R-plate reconstruction. Flap survival, postoperative function, donor/recipient site complication and aesthetics were evaluated. RESULTS: Our series demonstrated a 99.1% flap survival rate. One case requi

Pathological fracture of primary lymphoma of bone: A case report on diagnosis and novel surgical management.

Primary lymphoma of bone (PLB) is an uncommon malignancy, representing ~4-5% of primary malignant bone tumors and 1% of all malignant lymphomas. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype, accounting for ~80% of cases, and is highly curable with appropriate treatment. Therefore, accurate and timely diagnosis is crucial for favorable outcomes. The current study presents a 42-year-old male with primary DLBCL of the proximal humerus. The initial diagnosis was challenging due to overlapping morphological features with other small round cell tumors like Ewing's sarcoma and sma

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… The hybrid technique described in this report addresses these limitations by combining the immediate mechanical stability of the modular reverse shoulder prosthesis with the biological advantages of the patient's own devitalized cortical bone. … prosthesis, elbow prosthesis, and polyetheretherketone: A modified total humeral replacement for osteosarcoma humerus treatment Case Rep Oncol 15 12 20 2022 10.1159/000519599 35221964 PMC8832199 17 Wisanuyotin T Paholpak P Sirichativapee W Kosuwon W Allograft versus autograft for reconstruction after …

Intramedullary Nailing for Pathological Fractures of the Proximal Humerus.

BACKGROUND: Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. METHODS: We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes. RESU

Does lateralisation of the centre of rotation in reverse shoulder arthroplasty avoid scapular notching? Clinical and radiological review of one hundred and forty cases with forty five months of follow-up.

PURPOSE: Our purpose was to evaluate the influence of metallic lateralisation of the centre of rotation (COR) in reverse shoulder arthroplasty (RSA) on the incidence of scapular notching and its eventual clinical and radiological consequences. METHODS: We analysed 140 RSAs with a lateralised design (Arrow, FH Orthopedics, Mulhouse, France) implanted for massive rotator cuff tear with/without arthritis. Mean follow-up was 45 months (range 24-120, standard deviation 20). Patients were evaluated clinically using the Constant and Murley (Clin Orthop Relat Res 214:160-164, 1987) score and active r

Tuberosity position correlates with fatty infiltration of the rotator cuff after hemiarthroplasty for proximal humeral fractures.

HYPOTHESIS: This study investigates the correlation between tuberosity positioning, fatty infiltration of the rotator cuff, and clinical outcome after hemiarthroplasty for proximal humeral fracture. MATERIALS AND METHODS: Twenty patients with a mean age of 70.8 +/- 9.9 years were evaluated at a mean of 19.8 +/- 9.4 months. Evaluation included assessment of the Constant score (CS); Disabilities of the Arm, Shoulder and Hand (DASH) score; radiographic evaluation; and computed tomography to classify healing of the tuberosities and changes in the rotator cuff. Fatty degeneration of the cuff was c

Modular prostheses in the treatment of proximal humerus metastases: review of 40 cases.

BACKGROUND: The humerus is the second most common site of metastatic bone disease involving long bones. Tumors which have a predilection for dissemination to bone are those of breast, prostate, thyroid, lung and kidney. The rationale for surgical treatment of these lesions is to prevent or treat pathological fractures in order to relieve pain and improve function. MATERIALS AND METHODS: Forty patients who had resection of the proximal humerus for metastatic bone disease and reconstruction with a modular prosthesis were retrospectively reviewed. RESULTS: Mean functional outcome was 73.1% (Enn

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… Grammont PM, Baulot E (1993) Delta shoulder prosthesis for rotator cuff rupture. Orthopedics 16(1):65–68 27. Frankle M, Siegal S, Pupello D et al (2005) The Reverse Shoulder Prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency. …

Muscle and joint-contact loading at the glenohumeral joint after reverse total shoulder arthroplasty.

The purposes of this study were to determine the contributions of each shoulder muscle to glenohumeral joint force during abduction and flexion in both the anatomical and post-operative shoulder and to identify factors that may contribute to the incidence of glenoid component loosening/failure and joint instability in the shoulder after reverse shoulder arthroplasty (RSA). Eight cadaveric upper extremities were mounted onto a testing apparatus. Muscle lines of action were measured, and muscle forces and muscle contributions to glenohumeral joint forces were determined during abduction and flex