Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Jun 2018
Bridging multimodal pain management provides 48-hour pain control in patients undergoing total shoulder replacement.
We report our experience with a bridging multimodal pain management program that provides comprehensive 48-hour pain control in patients undergoing total shoulder replacement (TSR). ⋯ This bridging multimodal pain management protocol resulted in a length of stay of 1 day for 66% of patients, even for higher-risk patients with American Society of Anesthesiologists Physical Status Classification III (63%). Of the 62 patients, 64% (n = 40) did not require postoperative intravenous narcotics. For properly selected patients, this program may be considered for performing TSR as an ambulatory procedure.
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J Shoulder Elbow Surg · Jun 2018
Comparative StudyCorrelation of Patient-Reported Outcomes Measurement Information System (PROMIS) scores with legacy patient-reported outcome scores in patients undergoing rotator cuff repair.
The Patient-Reported Outcomes Measurement Information System (PROMIS) is being used to assess outcomes in many patient populations despite limited validation. The purpose of this study was to investigate the relationship between American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) scores and PROMIS Physical Function (PF) and Upper Extremity (UE) function scores collected preoperatively in patients undergoing rotator cuff repair. ⋯ PROMIS UE scores indicate greater impairment and demonstrate a stronger correlation with the legacy shoulder scores than PROMIS PF scores in patients with symptomatic rotator cuff tears. PROMIS computerized adaptive tests allow for more efficient patient-reported outcome data collection compared with traditional outcome scores.
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J Shoulder Elbow Surg · Jun 2018
Current pain prescribing habits for common shoulder operations: a survey of the American Shoulder and Elbow Surgeons membership.
Orthopedic surgeons are among the highest prescribers of narcotic pills, and no guidelines currently exist for appropriate management of postoperative pain within this field. The purpose of this study was to gain understanding of the current pain management strategies used perioperatively and postoperatively among orthopedic shoulder surgeons. ⋯ The majority of shoulder surgeons use a standard pain management protocol in perioperative and postoperative settings. Regimens frequently include a regional nerve block, nonsteroidal anti-inflammatory drugs, and short-acting oral narcotics. Findings from this study provide guidelines on standard pain management strategies for common shoulder operations based on expert opinion.
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J Shoulder Elbow Surg · Jun 2018
Morphometry of the radiocapitellar joint: is humeral condyle diameter a reliable predictor of the size of the radial head prosthesis?
Radial head arthroplasty (RHA) is a reliable procedure to manage complex injuries of the elbow, but complications due to inadequate sizing have been observed. Radiocapitellar morphometry has been studied widely, but RHA preoperative planning is not yet well defined. We hypothesized that specific morphologic parameters of the radiocapitellar joint measured with simple clinical software for radiographic analysis could be useful tools for clinical practice to predict RHA size preoperatively. ⋯ Radiologic radiocapitellar parameters show good interobserver reliability. RHADi can be calculated preoperatively from HCDi on the lateral view in 67% of cases.