The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Aug 2003
Shoulder arthroplasty in patients with a prior anterior shoulder dislocation. Results of a multicenter study.
Prior reports of shoulder arthroplasty performed for dislocation-induced arthropathy have included only patients who had had a prior stabilizing procedure. The purpose of this study was to report the results of shoulder arthroplasty in all patients with a prior anterior shoulder dislocation, including both those previously treated operatively and those previously treated nonoperatively. ⋯ This investigation documented the good results obtainable with shoulder arthroplasty for the treatment of arthritis following anterior shoulder instability. In addition, our findings suggest that capsulorrhaphy-induced arthropathy may be indistinguishable from arthritis following nonoperatively treated anterior shoulder instability.
-
J Bone Joint Surg Am · Aug 2003
Arthroscopic posterior labral repair and capsular shift for traumatic unidirectional recurrent posterior subluxation of the shoulder.
The purpose of this study was to evaluate the results of arthroscopic treatment of traumatic unidirectional recurrent posterior subluxation of the shoulder. ⋯ Arthroscopic posterior labral repair and capsular shift to treat traumatic unidirectional recurrent posterior subluxation is a reliable procedure with respect to providing stability, pain relief, and functional restoration.
-
J Bone Joint Surg Am · Aug 2003
Comparative StudyA single percutaneous injection of recombinant human bone morphogenetic protein-2 accelerates fracture repair.
Recombinant human bone morphogenetic protein-2 (rhBMP-2), surgically implanted with a matrix material, has been shown to induce bone formation and enhance fracture repair. The purpose of this investigation was to test the hypothesis that a single, local, percutaneous injection of rhBMP-2 would accelerate fracture-healing in a standard rat femoral fracture model. ⋯ These data demonstrate that a single, local, percutaneous injection of rhBMP-2 accelerates fracture repair in this rat femoral fracture model. This effect appears to result from a combination of the induction of bone formation at the fracture site and acceleration of the rate at which the fracture callus matures.
-
Surgery on the posterior aspect of the shoulder has become accepted practice for a number of pathological conditions affecting the scapula and the glenohumeral joint. Despite this trend, the anatomy of the posterior branch of the axillary nerve has not been well characterized. The purpose of the present study was to determine the innervation pattern and surgical relationships of the posterior branch of the axillary nerve. ⋯ The posterior branch of the axillary nerve has an intimate association with the inferior aspects of the glenoid and shoulder joint capsule, which may place it at particular risk during capsular plication or thermal shrinkage procedures. The superior-lateral brachial cutaneous nerve and the nerve to the teres minor always arise from the posterior branch. Thus, loss of sensation over the deltoid may indicate loss of teres minor function. The posterior aspect of the deltoid has a more consistent supply from the anterior branch of the axillary nerve, necessitating caution when performing a posterior deltoid-splitting approach to the shoulder.