The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Dec 2014
Comparative StudyArthroscopic repair of anterosuperior rotator cuff tears: in-continuity technique vs. disruption of subscapularis-supraspinatus tear margin: comparison of clinical outcomes and structural integrity between the two techniques.
The purpose of this study was to compare the clinical outcomes and structural integrity after two techniques of arthroscopic anterosuperior rotator cuff repair: in continuity and disruption of the tear margin. ⋯ In conclusion, in patients treated with arthroscopic repair of anterosuperior full-thickness subscapularis and supraspinatus tears of the rotator cuff, the technique of in-continuity repair did not produce better clinical outcomes or structural integrity than the technique involving disruption of the tear margin. If the muscle in an anterosuperior rotator cuff tear is of good quality, it does not appear to matter whether the tear margin between the subscapularis and supraspinatus is preserved or disrupted.
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J Bone Joint Surg Am · Dec 2014
Reverse shoulder arthroplasty for the treatment of nonunions of the surgical neck of the proximal part of the humerus (type-3 fracture sequelae).
Fracture sequelae of the proximal part of the humerus are challenging conditions, and various treatment options have been described. The purpose of this multicenter study was to analyze the clinical and radiographic outcomes as well as the complications following semiconstrained reverse total shoulder arthroplasty for the treatment of nonunion of a surgical neck fracture of the proximal part of the humerus. ⋯ Nonunions of the proximal part of the humerus can be treated with reverse shoulder arthroplasty. Although clinical outcomes improved significantly, we found an unacceptably high rate of dislocations associated with intraoperative resection of the tuberosities. The tuberosities and the attached rotator cuff should be preserved if possible to reduce the risk of dislocation after reverse total shoulder arthroplasty.
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J Bone Joint Surg Am · Dec 2014
Risk factors for poor outcome of cervical laminoplasty for cervical spondylotic myelopathy in patients with diabetes.
Diabetes is one of the most frequent comorbidities in patients with cervical spondylotic myelopathy. The purpose of this study was to characterize the risk factors for poor treatment outcome following cervical laminoplasty for cervical spondylotic myelopathy in patients with diabetes. ⋯ Diabetes with advanced age and long-term cervical spondylotic myelopathy symptoms adversely affected cervical laminoplasty outcomes. High preoperative glycated hemoglobin levels and long-term diabetes are risk factors for poor cervical laminoplasty outcomes in patients with diabetes and cervical spondylotic myelopathy.
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J Bone Joint Surg Am · Dec 2014
ReviewRepair techniques for acute distal biceps tendon ruptures: a systematic review.
There is a lack of consensus regarding the optimal surgical approach and fixation method for distal biceps tendon ruptures. The purpose of this study was to conduct a systematic review comparing the results of the various surgical approaches and repair techniques for acute distal biceps tendon ruptures. ⋯ The complication rate did not differ significantly between one and two-incision distal biceps repairs; however, the bone tunnel and cortical button methods had significantly lower complication rates compared with suture anchors and intraosseous screws. Further studies are needed to determine the optimal number of incisions.
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J Bone Joint Surg Am · Dec 2014
Postoperative myocardial infarction and cardiac arrest following primary total knee and hip arthroplasty: rates, risk factors, and time of occurrence.
Cardiac complications are a major cause of postoperative morbidity. The purpose of this study was to determine the rates, risk factors, and time of occurrence for cardiac complications within thirty days after primary unilateral total knee arthroplasty and total hip arthroplasty. ⋯ An age of eighty years or more, a history of cardiac disease, and hypertension requiring medication are significant risk factors for developing postoperative cardiac complications following primary unilateral total knee arthroplasty and total hip arthroplasty. Consideration should be given to a preoperative cardiology evaluation and co-management in the perioperative period for individuals with these risk factors.