Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Jul 2020
Meta Analysis Comparative StudyConservative vs. operative treatment for humeral shaft fractures: a meta-analysis and systematic review of randomized clinical trials and observational studies.
This meta-analysis aimed to compare conservative vs. operative treatment for humeral shaft fractures in terms of the nonunion rate, reintervention rate, permanent radial nerve palsy rate, and functional outcomes. Secondarily, effect estimates from observational studies were compared with estimates of randomized clinical trials (RCTs). ⋯ This systematic review shows that satisfactory results can be achieved with both conservative and operative management; however, operative treatment reduces the risk of nonunion compared with conservative treatment, with comparable reintervention rates (for indications other than nonunion). Furthermore, operative treatment results in a similar permanent radial nerve palsy rate, despite its inherent additional surgery-related risks. No difference in mean time-to-union and short-term functional results was detected.
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J Shoulder Elbow Surg · Jul 2020
Salvage reverse total shoulder arthroplasty for failed anatomic total shoulder arthroplasty: a cohort analysis.
Reverse total shoulder arthroplasty (RTSA) as a revision procedure for failed anatomic total shoulder arthroplasty (TSA) is increasing in incidence. The purpose of this study was to analyze the results of RTSA as a revision salvage procedure for failed TSA and identify factors that influenced those outcomes. ⋯ RTSA for failed TSA can improve pain, function, and quality-of-life measures in patients with various TSA failure etiologies. However, postoperative ROM and patient-reported outcomes do not reach the values seen in the primary RTSA population.
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J Shoulder Elbow Surg · Jul 2020
Cortical suture button fixation vs. bicortical screw fixation in the Latarjet procedure: a biomechanical comparison.
The Latarjet procedure traditionally has been performed with 2 screws in an open manner. Recently, cortical suture button fixation for coracoid transfer has been used in hopes of mitigating complications seen with screw placement. The aim of this study was to evaluate a cortical suture button and technique currently available in the United States compared with screw fixation in the Latarjet procedure in a cadaveric model. ⋯ At time zero, the cortical button fixation and technique did not resist direct loads to the graft as much as traditional screw fixation, although bony damage to the surrounding anatomy was more extensive in screw fixation than button fixation. In the event of unanticipated loading, this could place a patient at higher risk of graft migration, which could lead to unintended early outcomes. These results support the need for implants and techniques specifically tailored to the Latarjet procedure and should bring into question the adoption of a cortical button and technique not specific to the procedure.
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J Shoulder Elbow Surg · Jul 2020
Randomized Controlled Trial Comparative StudyEffectiveness of radial extracorporeal shock-wave therapy versus ultrasound-guided low-dose intra-articular steroid injection in improving shoulder pain, function, and range of motion in diabetic patients with shoulder adhesive capsulitis.
To compare the efficacy of radial extracorporeal shock-wave therapy (rESWT) vs. an ultrasound-guided low-dose intra-articular steroid injection in pain reduction and functional improvement in diabetic patients with shoulder adhesive capsulitis (AC).
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J Shoulder Elbow Surg · Jul 2020
Early results of reverse total shoulder arthroplasty using a patient-matched glenoid implant for severe glenoid bone deficiency.
Reverse total shoulder arthroplasty (rTSA) in the presence of significant glenoid bone loss remains a challenge. This study presents preliminary clinical and radiographic outcomes of primary and revision rTSA using a patient-matched, 3-dimensionally printed custom metal glenoid implant to address severe glenoid bone deficiency. ⋯ The preliminary results of rTSA using the VRS to manage severe glenoid bone deficiency are promising, but longer follow-up is necessary to determine the longevity of this implant.