Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · May 2019
Cutibacterium acnes in primary reverse shoulder arthroplasty: from skin to deep layers.
The aim of this study was to determine the presence of Cutibacterium acnes (formerly Propionibacterium acnes) on the skin and in deep tissue in a real clinical scenario of primary reverse shoulder arthroplasty. ⋯ In the real scenario of patients undergoing primary reverse shoulder arthroplasty using antibiotic prophylaxis and standard preoperative skin preparation with chlorhexidine, C acnes was isolated in the deep layers of 18.8% of the patients. The C acnes K1 and K2 subtypes (belonging to phylotype II and CC53), reported to be commonly involved in prosthetic joint infection, were usually isolated.
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J Shoulder Elbow Surg · May 2019
Long-term clinical outcome of arthroscopic Bankart repair with suture anchors.
The most common surgical technique in traumatic anterior shoulder instability is the arthroscopic Bankart repair, which has excellent short-term results. The long-term results of the arthroscopic Bankart repair are less frequently studied, with a high recurrence rate of 23% to 35%. The aim of this study was to evaluate the medium-term to long-term results of arthroscopic Bankart repair using suture anchors and to identify specific risk factors for recurrent instability. ⋯ We found an overall recurrent instability rate of 22% (dislocation or subluxation). Good long-term results were observed after arthroscopic Bankart repair in patients older than 20 years with 3 or more suture anchors used.
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J Shoulder Elbow Surg · May 2019
Shoulder arthroplasty after prior anterior stabilization procedures: do reverses have better outcomes?
Few studies have focused on shoulder arthroplasty after anterior stabilization procedures. This study compares the outcomes of total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) after anterior stabilization surgical procedures. ⋯ RTSA patients had better postoperative improvement in most ROMs and all functional scores; only the ASES score was statistically significant. This study suggests better outcomes with a lower complication rate with RTSA after prior anterior stabilization procedures compared with TSA.
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J Shoulder Elbow Surg · May 2019
Liposomal bupivacaine reduces opiate consumption after rotator cuff repair in a randomized controlled trial.
Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often associated with significant postoperative pain. The use of intraoperative anesthesia in conjunction with multimodal pharmacologic strategies is a widely accepted approach for managing surgical pain and reducing opiate use. The purpose of this study was to determine whether using a combined field and suprascapular nerve block with liposomal bupivacaine (LB) in addition to an interscalene block would provide greater pain relief and a reduction in opiate consumption compared with an interscalene block alone. ⋯ The findings of this study suggest that the addition of LB to multimodal anesthetic protocols significantly reduces the acute perioperative pain experienced following rotator cuff repair and the number of narcotic pills consumed in the first 5 days after ARCR. Furthermore, the findings provide guidelines for postoperative narcotic prescribing to reduce the quantity of opiates prescribed.