Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · May 2015
Blood transfusion in primary total shoulder arthroplasty: incidence, trends, and risk factors in the United States from 2000 to 2009.
Total shoulder arthroplasty (TSA) may be associated with substantial blood loss, and some patients require perioperative blood transfusion. Possible blood transfusion methods include predonated autologous blood transfusion, perioperative autologous blood transfusion, and allogeneic blood transfusion (ALBT). The purposes of the present study were to assess the incidence and recent trends over time of blood transfusion in TSA and analyze patient and hospital characteristics that affect the risk of ALBT. ⋯ The increase in overall blood transfusion rate in TSA found in the present study may be related to factors specific to TSA, such as the introduction of reverse total shoulder arthroplasty during the study period. A variety of patient and hospital characteristics contribute to the risk of undergoing ALBT.
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Surgical site infection (SSI) after joint arthroplasty is associated with prolonged hospitalization, reoperation, inferior outcomes, and substantial resource utilization. As the number of shoulder replacements performed in the United States continues to rise, measuring the incidence of inpatient SSI after hemiarthroplasty (HSA) and total shoulder arthroplasty (TSA), and associated risk factors for infection is worthwhile. ⋯ The small percentage of SSI that occurs during the initial inpatient stay after shoulder arthroplasty is related to diagnoses other than primary osteoarthritis in more infirm patients with low-income government insurance (Medicaid). Patients considering shoulder arthroplasty can use this information to help decide between the potential improvement in comfort and function of the shoulder and the potential for major adverse events such as infection.
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J Shoulder Elbow Surg · May 2015
The long-term outcome of displaced mid-third clavicle fractures on scapular and shoulder function: variations between immediate surgery, delayed surgery, and nonsurgical management.
Conservative management for uncomplicated displaced clavicle fractures is common practice. Delay of surgical fixation may result in less favorable outcomes. ⋯ We support the conservative management of uncomplicated displaced clavicle fractures but recognize that a lower threshold for early surgery should be considered where optimal shoulder function is required.