Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · May 2004
Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder.
Clinical experience with the Copeland cementless surface replacement arthroplasty (CSRA) of the shoulder now spans 17 years. Between 1986 and 1997, 79 CSRAs (42 total shoulder replacements and 37 hemiarthroplasties) were performed for primary osteoarthritis of the shoulder. Total shoulder replacement was done in 12 men and 30 women with a mean age of 71.5 years (range, 50-87 years). ⋯ With use of the CSRA prosthesis, several severe complications mainly concerning the humeral shaft and periprosthetic fractures can be avoided. Should the need for revision surgery or arthrodesis arise, these procedures are easily performed, as bone stock has been maintained and no loss of length has been encountered. It does seem that the humeral component does not need a stem or cement for fixation.
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J Shoulder Elbow Surg · May 2004
Entrapment of the long head of the biceps tendon: the hourglass biceps--a cause of pain and locking of the shoulder.
We describe an unrecognized mechanical condition affecting the long head of the biceps (LHB) tendon with entrapment of the tendon within the joint and subsequent pain and locking of the shoulder on elevation of the arm. We identified 21 patients with a hypertrophic intraarticular portion of the LHB tendon during open surgery (14 patients) or arthroscopic surgery (7 patients). All cases but one were associated with a rotator cuff rupture. ⋯ Simple tenotomy cannot resolve this mechanical block. Excision of the intraarticular portion of the LHB tendon, during bipolar biceps tenotomy or tenodesis, must be performed. The hourglass biceps is an addition to the familiar pathologies of the LHB (tenosynovitis, prerupture, rupture, and instability) and should be considered in cases of shoulder pain associated with a loss of elevation.
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J Shoulder Elbow Surg · Nov 2003
Comparative StudyA cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair.
A basic principle in the treatment of joint injuries is to restore congruity with the hope that restoration may lessen the incidence of late arthritis. The acromioclavicular (AC) joint is frequently injured. Many AC joint injuries are treated nonoperatively; others are treated surgically. ⋯ The techniques only varied by the placement of the drill hole in the clavicle (ie, either posterior, middle, or anterior). The results of this study indicate that as the drill hole moved anteriorly on the clavicle, joint congruity was more closely approached and less anterior displacement of the clavicle occurred. However, none of the methods of coracoclavicular loop fixation restored full AC joint congruity.
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J Shoulder Elbow Surg · Nov 2003
Clinical outcome of the treatment of floating shoulder by osteosynthesis for clavicular fracture alone.
Floating shoulder is an unstable combination of fractures that involve the scapular neck and the ipsilateral midclavicle and require surgical treatment. The clinical outcome of the surgical treatment of floating shoulder for the clavicular fracture alone is reported. ⋯ According to the UCLA score, the mean score was 34.2 points during a mean follow-up period of 57.4 months. In patients with a floating shoulder, it is important to evaluate the severity of fracture displacement and coracoclavicular ligament rupture accurately, and on the basis of this evaluation, an appropriate treatment for both fractures that may lead to a satisfactory clinical outcome can be determined.